High Post-Stroke Glucose Levels Linked With Faster Cognitive Decline
High post-stroke glucose levels were associated with faster cognitive decline in a recent meta-analysis published in JAMA Network Open.
“These findings suggest that higher cumulative glucose levels may contribute to faster cognitive decline in stroke survivors, representing a potential treatment target to preserve cognition after stroke,” said lead author Deborah A. Levine, MD, MPH, Department of Internal Medicine and Cognitive Health Services Research Program, University of Michigan, Ann Arbor, Michigan, and co-authors.
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Data from 4 US cohort studies conducted between 1971 and 2019 was included, with a median follow-up period of 4.7 years. The analysis, beginning in August 2021 and concluding in March 2023, utilized linear mixed-effects models to estimate cognitive changes after incident stroke. A total of 1,120 dementia-free individuals with incident stroke were identified, of which 982 had available covariate data. The participants had a median age of 74.6 years at the time of stroke, with 48.9% being female and 29.4% being Black individuals
The analysis revealed that cumulative mean poststroke systolic blood pressure (SBP) and LDL cholesterol levels were not associated with any cognitive outcomes. However, higher cumulative mean poststroke glucose levels were linked to a faster decline in global cognition. For every 10-mg/dL increase in glucose, global cognition declined 0.05 points per year (95% CI, -0.09 to -0.01 points/year; P = .01). This association persisted even after controlling for the presence of the apolipoprotein E4 (APOE4) gene, which is associated with a higher risk of Alzheimer disease.
