Adults in their 60s who perform poorly on tests of thinking ability, memory, and information-processing speed may face a substantially higher risk of stroke later in life, according to new research published in the Journal of the American Heart Association. The study, conducted in Sweden, examined nearly 5,000 older adults without dementia or prior stroke, tracking their cognitive function and subsequent stroke events over an average of 12 years.
Researchers found that among participants aged 60 to 69, lower overall thinking ability was linked to an 86% higher risk of stroke compared to those with the highest scores. Lower memory scores corresponded to a 68% higher risk, and slower information-processing speed was associated with a 66% higher risk. These associations were not observed in participants aged 70 and older after adjusting for other health and lifestyle factors.
“We chose to investigate different age spans because the older population is very diverse,” said lead study author Alice Askemyr, M.D., a geriatrics researcher at Lund University and Skane University Hospital in Malmo, Sweden. “What serves as a risk factor in early life might not serve as one if it is acquired later in life and vice versa.” She noted that poor cognitive performance in the younger group could signal undetected brain injury, such as so-called “silent” strokes, which affect roughly 70% of adults over 70 and may be easier to detect in the 60s when other confounding factors are less common.
The findings suggest that simple cognitive testing in midlife could serve as a new screening tool to identify individuals at higher risk of stroke, including transient ischemic attack. Elisabeth Breese Marsh, M.D., FAHA, chair of the 2026 American Heart Association Scientific Statement, Brain Health Across the Life Span: A Framework for Future Studies, who was not involved in the study, emphasized that risk factor modification should begin even earlier. “While it is certainly important for people in their 60s, my advice would be that even people in their 40s and 50s need to be focusing on risk factor modification and habits for good overall brain health,” Marsh said. She added that the study supports aggressive management of vascular risk factors in midlife to improve both cognitive performance and stroke risk in older age.
According to the American Stroke Association, a division of the American Heart Association, overall health, lifestyle and environment can affect brain health and cognition over time. The study included 4,912 adults ages 60-80+ enrolled in the Good Aging in Skane project, with data collected from 2001 to 2023. During follow-up, 572 participants had a first-time stroke. Cognitive function was assessed using standardized tests of memory, processing speed, verbal fluency, and executive function.
Study limitations include its observational design, meaning it cannot prove cause and effect, and the findings may not be generalizable to other countries due to differences in healthcare, socioeconomics, and lifestyle habits. The research adds to growing evidence that midlife brain health is closely tied to cardiovascular outcomes. Additional resources are available, including the manuscript and related American Heart Association news releases such as Brain health shaped by lifetime mental, physical, environmental and lifestyle factors and Older adults’ driving habits offer window into brain health, cognitive decline. For more information on stroke prevention, see Stroke Risk Factors.
