Sajjad Ayesha, Mirza Saira Saeed, Portegies Marileen L P, Bos Michiel J, Hofman Albert, Koudstaal Peter J, Tiemeier Henning, Ikram M Arfan
From the Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands (A.S., S.S.M., M.L.P.P., M.J.B., A.H., H.T., M.A.I.); Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands (H.T.); Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands (M.A.I.); and Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands (M.L.P.P., P.J.K., M.A.I.).
Stroke. 2015 Jan;46(1):170-5. doi: 10.1161/STROKEAHA.114.006616. Epub 2014 Dec 11.
Persons with cognitive impairment, as assessed by cognitive tests, are at a higher risk of stroke. Subjective memory complaints might be an earlier marker for stroke, especially in persons with higher education. Their cognitive reserve might mask their cognitive impairment during cognitive testing. In a population-based setting, we investigated the association between subjective memory complaints and stroke. We simultaneously investigated the association between Mini-Mental State Examination and stroke. We also assessed whether these associations varied with educational level.
9152 participants from the Rotterdam Study (baseline 1990-1993 or 2000-2001) completed the subjective memory complaints questionnaire and underwent Mini-Mental State Examination assessment. Subsequently, the entire cohort was followed for incident stroke until 2012. We used Cox proportional hazard models to estimate the associations between subjective memory complaints and Mini-Mental State Examination, with stroke.
During a follow-up of 111 593 person years, 1134 strokes were identified, of which 663 were ischemic and 99 hemorrhagic. In the fully adjusted model, presence of subjective memory complaints was independently associated with a higher risk of stroke (hazard ratio, 1.20; 95% confidence interval, 1.04-1.39), but a higher Mini-Mental State Examination was not (hazard ratio per point increase, 0.99; 95% confidence interval, 0.95-1.02). The association between subjective memory complaints and risk of stroke was modified by educational level, with a higher risk of stroke in persons with a higher level of education (hazard ratio, 1.39; 95% confidence interval, 1.07-1.81).
Subjective memory complaints might be an early indicator of stroke risk, especially in highly educated individuals.
通过认知测试评估，认知功能受损者发生中风的风险更高。主观记忆抱怨可能是中风的早期标志物，尤其是在受过高等教育的人群中。他们的认知储备可能会在认知测试期间掩盖其认知功能障碍。在基于人群的研究中，我们调查了主观记忆抱怨与中风之间的关联。我们同时调查了简易精神状态检查表与中风之间的关联。我们还评估了这些关联是否因教育水平而异。
来自鹿特丹研究（基线为1990 - 1993年或2000 - 2001年）的9152名参与者完成了主观记忆抱怨问卷并接受了简易精神状态检查表评估。随后，对整个队列进行随访直至2012年，观察中风事件。我们使用Cox比例风险模型来估计主观记忆抱怨和简易精神状态检查表与中风之间的关联。
在111593人年的随访期间，共识别出1134例中风，其中663例为缺血性中风，99例为出血性中风。在完全调整模型中，存在主观记忆抱怨与中风风险较高独立相关（风险比，1.20；95%置信区间，1.04 - 1.39），但简易精神状态检查表得分较高则不然（每增加一分的风险比，0.99；95%置信区间，0.95 - 1.02）。主观记忆抱怨与中风风险之间的关联因教育水平而异，教育水平较高者中风风险更高（风险比，1.39；95%置信区间，1.07 - 1.81）。
主观记忆抱怨可能是中风风险的早期指标，尤其是在高学历个体中。
