Cognitive function in adolescence and the risk of early-onset stroke.

Autor:	Bardugo A; Department of Military Medicine, Hebrew University, Jerusalem, Israel.; Israel Defense Forces Medical Corps, Ramat Gan, Israel.; The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Bendor CD; Department of Military Medicine, Hebrew University, Jerusalem, Israel.; Israel Defense Forces Medical Corps, Ramat Gan, Israel.; The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel.; Department of Preventive Medicine and Epidemiology, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Libruder C; Israel Center for Disease Control, State of Israel Ministry of Health, Ramat Gan, Israel., Lutski M; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Israel Center for Disease Control, State of Israel Ministry of Health, Ramat Gan, Israel., Zucker I; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Israel Center for Disease Control, State of Israel Ministry of Health, Ramat Gan, Israel., Tsur AM; Department of Military Medicine, Hebrew University, Jerusalem, Israel.; Israel Defense Forces Medical Corps, Ramat Gan, Israel.; The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel.; Department of Preventive Medicine and Epidemiology, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Department of Medicine, Sheba Medical Center, Tel Hashomer, Israel., Derazne E; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel., Yaniv G; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel., Gardner RC; The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel., Gerstein HC; Department of Medicine, McMaster University, Hamilton, Ontario, Canada., Cukierman-Yaffe T; Department of Preventive Medicine and Epidemiology, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Israel., Lebenthal Y; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; The Institute of Pediatric Endocrinology, Diabetes and Metabolism, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel., Batty D; Department of Epidemiology and Public Health, University College London, London, UK., Tanne D; Rambam Health Care Campus and Rappaport Faculty of Medicine, Technion, Haifa, Israel., Furer A; Department of Military Medicine, Hebrew University, Jerusalem, Israel.; Israel Defense Forces Medical Corps, Ramat Gan, Israel., Afek A; Reichman University, Herzelia, Israel., Twig G; The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel Gilad.Twig@gmail.com.; Department of Preventive Medicine and Epidemiology, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Israel.
Jazyk:	angličtina
Zdroj:	Journal of epidemiology and community health [J Epidemiol Community Health] 2024 Aug 09; Vol. 78 (9), pp. 570-577. Date of Electronic Publication: 2024 Aug 09.
DOI:	10.1136/jech-2024-222114
Abstrakt:	Background: Stroke is increasingly prevalent at younger ages but the risk factors are uncertain. We examined the association between adolescent cognitive function and early-onset stroke. Methods: This was a nationwide population-based cohort study of 1 741 345 Israeli adolescents (42% women) who underwent comprehensive cognitive function tests at age 16-20 years, before mandatory military service, during 1987-2012. Cognitive function (range: 1-9) was categorised as low (1-3, corresponding to IQ score below 89), medium (4-7, IQ score range: 89-118), or high (8-9, IQ score above 118). Participant data were linked to the Israeli National Stroke Registry. Cox proportional hazard models were used to estimate risks for the first occurrence of ischaemic stroke during 2014-2018. Results: During 8 689 329 person-years of follow-up, up to a maximum age of 50 years, 908 first stroke events occurred (767 ischaemic and 141 haemorrhagic). Compared with a reference group of people with high cognitive function, body mass index-adjusted and sociodemographic-adjusted HRs (95% CIs) for early-onset stroke were 1.78 (1.33-2.38) in medium and 2.68 (1.96-3.67) in low cognitive function groups. There was evidence of a dose-response relationship ( P for trend <0.0001) such that one-unit of lower cognitive function z-score was associated with a 33% increased risk of stroke (1.33; 1.23-1.42). These associations were similar for ischaemic stroke but lower for haemorrhagic stroke; persisted in sensitivity analyses that accounted for diabetes status and hypertension; and were evident before age 40 years. Conclusions: Alongside adolescent obesity and hypertension, lower cognitive function may be a risk factor for early-onset stroke. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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