Steep declines in cognitive and daily functioning are present up to 10 years before a stroke occurs, a study of stroke patients’ long-term outlooks reveals.

Investigators tested the cognition and basic and instrumental activities of daily living in more than 14,700 participants between 1990 and 2016. During follow-up that lasted from six to 20 years, 1,662 of the participants experienced a first stroke. Even years before their stroke, these patients had notably different results on tests of function when compared with their peers who had never experienced a stroke, the researchers found.

Some stroke patients appeared to be more vulnerable to functional decline than others. These included women, people with greater genetic propensity for cognitive impairment and Alzheimer’s disease, and individuals with lower educational levels, reported M.K. Ikram, M.D., Ph.D., a clinical epidemiologist at Erasmus MC University Medical Center in the Netherlands.

The findings suggest that people accumulate brain pathologies that may clinically impact their lives well before a stroke occurs, Ikram and colleagues concluded. 

The researchers used data from the population-based Rotterdam Study. Full findings were published in the Journal of Neurology Neurosurgery & Psychiatry.