Complaints of Memory Loss May Signal Increased Stroke Risk Interview with:
M. Arfan Ikram, MD, PhD,and Ayesha Sajjad, MD

Department of Epidemiology
Erasmus University Medical Center, Rotterdam
Rotterdam, The Netherlands

Medical Research: What is the background for this study? What are the main findings?

Response: The occurrence of cognitive impairment and dementia after a stroke event are already known. Since these neuro-degenerative processes and stroke share vascular pathways in their pathogenesis such as small vessel disease, we aimed to study whether early cognitive impairment can be predictive of stroke onset in the elderly. We also hypothesized that a higher cognitive reserve (due to higher education attainment) may mask early symptoms of memory loss and thus put these older individuals at a higher risk of stroke. We found that self-reported subjective memory complaints as answered by a single question: “ Do you have memory complaints?” was highly predictive of stroke especially in older persons who were highly educated. In comparison, objective measures of cognitive impairment such as MMSE did not show any association with the risk of stroke.

Medical Research: What should clinicians and patients take away from your report?

Response: Complaints about memory in the elderly population should be investigated further. Older persons, especially who have high education status should be vigilantly monitored for any complaints in their memory status. Incorporation of a single question about memory in routine clinical evaluation may prompt screening and treatment of vascular risk factors in order to prevent incident stroke.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Future research using neuro-imaging data is needed for early detection of small vessel disease in persons who complain about their memory. This may also guide stratification of persons with vascular risk factors into risk categories for early prevention of stroke.


Subjective Memory Complaints and the Risk of Stroke

Ayesha Sajjad, Saira Saeed Mirza, Marileen L.P. Portegies, Michiel J. Bos, Albert Hofman, Peter J. Koudstaal, Henning Tiemeier, and M. Arfan Ikram

Stroke. 2014;STROKEAHA.114.006616published online before print December 11 2014, doi:10.1161/STROKEAHA.114.006616