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Can memory woes foretell a stroke?

Well-educated people who report memory problems may face a higher risk of stroke.

Minor memory slips—such as losing your keys or forgetting an acquaintance’s name—are common as we age. However, people who express concern about their memory may have a heightened risk of stroke, particularly if they’re highly educated, according to a study in the January 2015 Stroke.

More than 9,100 people ages 55 and older were asked, “Do you have memory complaints?” One in nine suffered a stroke during the follow-up, which lasted an average of 12.2 years. Over all, 20% of those reporting memory loss had a stroke. But the rate was 39% among people who had the highest levels of education, defined as university or advanced vocational training.

Microvascular damage and stroke

A stroke occurs when a blood vessel supplying the brain is either blocked by a clot or bursts. Brain cells die, which can affect your ability to move, speak, see, and think. Tiny strokes that affect very small blood vessels, known as microvascular damage, may go unnoticed, which is why they’re known as silent strokes. But over time, the damage can lead to memory or thinking problems—and can foretell a larger, more serious stroke.

Image: Thinkstock

An early warning sign

Subjective memory complaints are an early sign of damage to very small blood vessels in the brain. But the effects of education are a bit complicated, says Dr. Anand Viswanathan, a neurologist at the Stroke Service and Memory Disorders Unit at Harvard-affiliated Massachusetts General Hospital.

“Education and intellectual activities may help people develop more widespread neural connections, known as cognitive reserve,” he explains. This brain-cell backup may help them compensate for damage caused by tiny, unnoticed strokes. However, educated people also tend to be tuned in to their health and more likely to notice subtle changes in their memory. As a result, the correlation between these complaints and cerebrovascular damage is stronger and therefore a better predictor of a full-blown stroke.

“In other words, education doesn’t increase stroke risk. But in educated people who are at a higher risk for stroke, subjective memory complaints are a more reliable marker of future stroke risk than in people with less education,” says Dr. Viswanathan.

Distinguishing between normal age-related memory loss and more worrisome changes isn’t always easy. For help, see “Memory loss: When should you worry?” If you have concerns, your health care provider can do a simple office-based test. He or she may refer you to neurologist or other specialist for additional testing. But regardless of your education level or current memory status, you can take steps to prevent or delay memory loss.

Watch your blood pressure

The prime culprit behind microvascular damage and stroke is high blood pressure. In fact, people with high blood pressure are more prone to memory problems than those with normal blood pressure.

However, high blood pressure is notoriously poorly controlled. Up to 40% of people with high blood pressure don’t have it under control despite taking medications. “I encourage my patients to buy a home blood pressure monitor to make sure they’re at their recommended blood pressure goal and are adequately treated,” says Dr. Viswanathan. If you’re not on target, call your health care provider about a possible medication adjustment.

Exercise is equally important. Many studies show a strong link between regular physical activity and brain health, probably because exercise helps lower blood pressure and prevent problems such as a stroke. And it’s never too late to build cognitive reserve by doing intellectually stimulating activities. “Do things you enjoy, whether it’s reading books, listening to music, or anything else that stimulates your brain.” says Dr. Viswanathan.

Memory loss: When should you worry?

Probably normal aging

Memory problems of possible concern

Walking into a room and forgetting why
you entered.

Getting lost in familiar surroundings.

Having trouble recalling the names of unfamiliar people.

Having difficulty remembering important details of recent events.

A change in memory compared with
when you were younger.

Difficulty following the plot of a television program or book because of memory problems.

Memory changes similar to other people of the same age.

Memory problems that are worse than
those of people your same age.

Misplacing items, but later recalling
where you put them.

Misplacing items and being unable to
relocate them later.

Source: Dr. Rebecca Amariglio, Harvard Medical School

Posted by: Dr.Health

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