TL;DR
Turn quiet afternoons into listening time
- Thousands of audiobooks, podcasts and originals
- Listen on your phone, tablet or Echo — also offline
- Cancel anytime
A Swedish study published in the Journal of the American Heart Association found that adults aged 60-69 with lower scores on thinking, memory and processing-speed tests had a 66-86% higher risk of first-time stroke over 12 years of follow-up. The association was not seen in participants aged 70 and older. The study is observational and cannot prove cause and effect.
Adults in their 60s who scored lower on tests of overall thinking ability, memory and information-processing speed were more likely to have a stroke years later, according to a Swedish study published September 30, 2026, in the Journal of the American Heart Association. Among participants aged 60-69, lower overall thinking ability was linked to an 86% higher risk of stroke, researchers reported, and the association was not seen in adults 70 and older.
The study followed 4,912 adults aged 60 to 80 and older enrolled in the Good Aging in Skåne project in Sweden, using health data from the Swedish Board of Health Welfare collected between 2001 and 2023. None of the participants had a history of dementia, stroke or transient ischemic attack (often called a mini-stroke) at enrollment. They completed standardized tests measuring overall thinking ability, memory, processing speed, verbal fluency and executive function, with results grouped into low, middle and high performance by age.
During an average follow-up of 12.3 years, 572 participants — more than 10% of the cohort — had a first-time stroke, identified through the Swedish National Patient Register of specialized in- and outpatient care. Comparing the lowest to the highest cognitive scorers among adults aged 60-69, the researchers found lower overall thinking ability was associated with an 86% higher stroke risk, lower memory scores with a 68% higher risk, and lower processing-speed scores with a 66% higher risk.
The same pattern did not appear among adults aged 70-79 or 80 and older once researchers accounted for other health and lifestyle factors. Lead author Alice Askemyr, M.D., a geriatrics researcher at Lund University and Skåne University Hospital in Malmö, said the age breakdown was deliberate because the older population is diverse: people in their 60s often have few medical conditions, while people in their 80s frequently have multiple conditions and take numerous medications.
Why Midlife Cognitive Screening May Matter
The findings suggest that cognitive test performance in early later life could serve as a marker for future stroke risk — and potentially as a screening tool to identify people who would benefit from closer management of vascular risk factors. Stroke is a leading cause of death and disability, and existing prevention relies heavily on factors such as blood pressure, cholesterol and smoking status. A cognitive signal in adults in their 60s could add an earlier warning.
The study also supports a broader shift in brain-health thinking: that risk reduction should begin in midlife, before most people consider it. Elisabeth Breese Marsh, M.D., chair of the 2026 American Heart Association scientific statement on brain health, who was not involved in the study, said it “supports how important it is to be aggressive in managing vascular risk factors and focusing on brain health in midlife,” adding that doing so “would improve both cognitive performance and stroke risk in older age.”
Popular right now
TCL QM64L 85-Inch QD-Mini LED 4K Smart Fire TV
TCL T7 Series 85-Inch 4K 144Hz QLED Smart Google TV
Ninja DualZone 6-in-1 Air Fryer, 8-Qt, Grey, DZ801
As an affiliate, we earn on qualifying purchases.
How the Study Was Designed
The research drew on the Good Aging in Skåne project, a long-running Swedish population study of aging, combined with national register data on stroke hospitalizations. Participants were 46% men, all aged 60 or older at enrollment, and cognitive scores were combined into composites grouped by age into low, middle and high performance.
The researchers chose to analyze separate age spans because risk factors acquired early in life may behave differently from those acquired later. Askemyr noted that poor cognitive performance among younger participants could indicate an undetected “silent” brain injury. “So-called ‘silent’ brain injuries can affect both cognitive functioning and the future risk of stroke,” she said, adding that such injuries affect roughly 70% of adults over age 70, which may explain why the cognitive-stroke link was easier to detect among people in their 60s, when such injuries and other cognition-affecting factors are less common.
“So-called ‘silent’ brain injuries can affect both cognitive functioning and the future risk of stroke. They affect roughly 70% of adults over age 70, so their effects may be easier to detect among people in their 60s.”
— Alice Askemyr, M.D., lead study author, Lund University and Skåne University Hospital
Limits of the Cognitive-Stroke Link
The study was observational: it found an association between lower cognitive scores and stroke risk but cannot prove that one causes the other. It remains unknown whether cognitive impairment itself raises stroke risk, or whether both stem from shared underlying causes such as silent brain injuries or vascular disease. The study also did not examine whether cognitive testing added predictive value beyond established stroke risk factors.
Askemyr noted the findings may not generalize to other countries because of differences in healthcare systems, socioeconomic conditions and lifestyle habits. Whether cognitive screening could feasibly be incorporated into routine stroke-risk assessment is not addressed by the research.
Toward Cognitive Testing in Clinics
The study raises the possibility that cognitive tests could become part of stroke risk assessment, a question Marsh said warrants further research. Future work is likely to examine whether cognitive scores improve risk prediction beyond standard vascular factors, and whether intervening on modifiable risk factors in people with lower scores reduces subsequent stroke incidence. In the meantime, both the researchers and outside experts emphasized that managing vascular risk factors in midlife — before and during a person’s 60s — remains the actionable advice, and individuals concerned about memory or thinking changes should discuss them with a qualified healthcare professional.
Key Questions
Does the study prove that lower cognitive scores cause strokes?
No. The study was observational and found an association only. The authors and outside experts note it cannot establish cause and effect, and shared underlying factors such as silent brain injuries may explain the link.
How much higher was the stroke risk for people in their 60s with lower scores?
Compared with those who had the highest scores, adults aged 60-69 with lower overall thinking ability had an 86% higher risk of stroke; lower memory scores were linked to a 68% higher risk and lower processing-speed scores to a 66% higher risk over roughly 12 years of follow-up.
Why was the link not found in adults 70 and older?
After accounting for health and lifestyle factors, the pattern disappeared in participants aged 70-79 and 80+. The lead author suggests that silent brain injuries, multiple medical conditions and medications are more common at older ages, making the cognitive signal harder to detect.
Should people in their 40s and 50s be concerned?
While the study covered ages 60 and older, Marsh advised that people in their 40s and 50s should focus on modifying risk factors and building habits for good brain health. Anyone worried about memory or thinking changes should speak with a qualified healthcare professional.
Who was included in the study?
The study included 4,912 Swedish adults aged 60 to 80 and older (46% men) with no history of dementia, stroke or transient ischemic attack, enrolled between 2001 and 2023 in the Good Aging in Skåne project, with stroke events tracked through national patient registers.
Source: rss
