Stroke: The early warning signs of a stroke that could appear 10 years before an incident


Many studies have highlighted the likelihood of steep decline in cognitive health following a stroke incident, with some sufferers going on to develop dementia. New research suggests that the decline in cognitive function may develop years before the stroke incident has even occurred.

A study, published in the Journal of Neurology Neurosurgery & Psychiatry suggests that warning signs of stroke could appear up to 10 years before an incident.

The study, which included almost 15,000 participants, found that stroke patients showed signs of decreased cognitive function when assessed for memory, verbal fluency, reaction times and manual dexterity.


The participants were assessed on their cognitive ability, and manual tasks such as washing and dressing, for an average of 12.5 years to identify when these changes started.

The findings showed that stroke sufferers showed signs of significantly steeper decline in cognitive function and routine daily functioning prior to a stroke.

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The signs of cognitive decline started about a decade before the patients’ first stroke.

Cognitive function refers to a person’s ability to learn, reason, think, make decisions, remember and pay attention.

The team also noted that women, who have a higher likelihood of developing Alzheimer’s because they carry the APOE gene, appeared to be at greater risk of having a stroke.


Previous studies had observed cognitive decline four to six years before a stroke. This study was the first to observe such early signs in cognitive decline.


The scientists, based in the Netherlands, established “significant differences” in the cognitive ability of stroke sufferers, compared to stroke-free participants.


They noted that the decline was likely attributable to the damage in blood vessels, which increased the risk of stroke.

They said: “Our findings demonstrated future stroke patients start to deviate from stroke-free controls up to ten years before the acute event.

“The accelerated decline in cognition and daily functions before stroke suggests individuals with future stroke suffer from accumulating inter-cerebral damage years before the acute event, such as cerebral small vessel disease, neurodegeneration, and inflammation.


Stroke is one of the leading causes of death and disability in the UK, affecting around 100,000 people annually.

Previous research had suggested it is relatively common for people to experience deterioration in cognitive skills following a stroke.

As many as two-thirds of stroke sufferers will experience cognitive impairment following an incident, with approximately a third developing dementia.


Some demographic factors, including age, lower education level, and other stroke related-factors are associated with cognitive decline following an acute incident.

Risk factors for strokeAccording to the Stroke Association, some risk factors for stroke include:

High cholesterol: High cholesterol causes fatty deposits to build up in the arteries, making them narrowed and stiff. As blood struggles to flow through the arteries, this heightens the risk of a stroke.


Diabetes: Diabetes almost doubles your risk of having a stroke. Having high blood glucose can cause considerable damage to the blood vessels, making them stiff and causing a build up of fatty acids.

High blood pressure: Extremely high blood pressure, with systolic pressure at 180mm Hg and diastolic pressure of 120 mm Hg or higher, can damage the blood vessels and lead to a stroke.

Heart disease: Coronary heart disease increases your risk for stroke, because plaque builds up in the arteries and blocks the flow of oxygen rich blood to the brain.


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