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Hyperglycemia After Stroke Associated With Faster Cognitive Decline
Higher blood glucose in stroke survivors was associated with faster decline in global cognition, according to a study published online in JAMA Network Open.
“These findings suggest that higher cumulative blood sugar levels after stroke contribute to faster cognitive decline and hyperglycemia after stroke, regardless of diabetes status, could be a potential treatment target to protect post-stroke cognition,” wrote corresponding author Deborah A. Levine, MD, MPH, of the University of Michigan in Ann Arbor, and study coauthors.
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“We found no evidence that poststroke systolic blood pressure and low-density lipoprotein (LDL) cholesterol levels were associated with cognitive decline.”
The study pooled, harmonized, and analyzed data from 4 long-term studies that included 982 dementia-free individuals with incident stroke. Participants had detailed assessments of brain function and blood tests from years before and after their strokes. Nearly 800 participants also had a gene test for the apolipoprotein E4 (APOE4) variation associated with increased Alzheimer disease risk.
Higher cumulative poststroke glucose level was associated with faster global cognitive decline after accounting for poststroke systolic blood pressure and LDL cholesterol levels, according to the study. For each 10–mg/dL increase in glucose level, global cognition decreased 0.04 points faster per year. Among 798 participants with APOE4 data, higher poststroke glucose was associated with a faster global cognitive decline both before and after adjusting for poststroke systolic blood pressure and LDL cholesterol.
Poststroke glucose level did not affect executive function or memory in participants, however. Additionally, cumulative average poststroke systolic blood pressure and LDL cholesterol levels were not linked with cognitive outcomes.
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