Adults in their 60s who perform worse on tests of thinking ability, memory, and processing speed are significantly more likely to suffer a stroke later in life, according to new research published in the Journal of the American Heart Association. The study, conducted in Sweden, followed nearly 5,000 adults aged 60 to 80+ for an average of 12 years and found that among those in their 60s, lower overall thinking ability was associated with an 86% higher risk of stroke, lower memory scores with a 68% higher risk, and lower information-processing speed with a 66% higher risk. No such pattern was 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. She noted that poor cognitive performance in the younger group could signal an undetected brain injury. “So-called ‘silent’ brain injuries can affect both cognitive functioning and the future risk of stroke,” Askemyr explained.
The findings suggest that simple cognitive testing in one’s 60s might serve as a new screening tool to identify individuals at higher risk for stroke, potentially allowing for earlier interventions. “This study, in conjunction with others, supports how important it is to be aggressive in managing vascular risk factors and focusing on brain health in midlife, before many people typically begin to think about it,” said 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. Marsh, who was not involved in the study, added that even people in their 40s and 50s should focus on risk factor modification.
The study included 4,912 adults with no history of dementia or stroke, including transient ischemic attack. During follow-up, 572 participants had a first-time stroke. Cognitive function was assessed using standardized tests, and scores were grouped into low, middle, and high performance. The research was observational, so it cannot prove cause and effect, and results may not be generalizable to other countries.
For the public, the message is clear: midlife brain health matters. According to the American Stroke Association, lifestyle and environment can affect brain health and cognition over time. Key Stroke Risk Factors include high blood pressure, diabetes, and smoking, all of which can be managed. The study’s findings underscore the potential of cognitive screening to prompt earlier risk reduction. For more information, visit heart.org or stroke.org. The manuscript will be available online after Sept. 30, 2026, at manuscript.
