Surviving a stroke can have many long-term consequences, including an increased risk of dementia. However, one study suggests that blood sugar levels may play an important role in this risk. According to a study published in JAMA Network Open, loss of general thinking ability occurred more rapidly in stroke survivors who had high blood glucose in the years following their health crisis, even accounting for other things. Even after that which could affect the power of his brain.
People who had high blood pressure or cholesterol after their stroke did not have reduced scores on tests of thinking ability, also known as global cognition. The researchers found the same results when they focused on people at high genetic risk of dementia.
Led by researchers from the University of Michigan Medicine, Academic Medical Center, the study is based on data from the STROKE COG study, which collected, harmonized and analyzed data from four long-term studies of groups of people over four decades.
The study included data from nearly 1,000 people who had detailed measurements of brain function and blood tests taken for years before and after having a stroke – including 781 who had two or more brain function changes in the years following their stroke. Tests were done. About 800 people in the entire group were also gene tested for the APOE4 genetic variation that is associated with a higher risk for Alzheimer’s disease.
“Having a stroke increases a person’s risk of dementia by up to 50-fold, but we lack a comprehensive treatment approach that can reduce this risk, other than preventing another stroke,” said Deborah A. Levin, MD, MPH, first author. study and professor of medicine and neurology at the UM Medical School, whose previous work showed the role of stroke in accelerated cognitive decline.
“These findings suggest that high cumulative blood glucose levels contribute to rapid cognitive decline after stroke, and that hyperglycemia after stroke may be a potential treatment target to protect post-stroke cognition, regardless of diabetes status.” It is possible.”
The researchers adjusted the data for differences in age, income, education, tobacco and alcohol use, body mass index, heart disease, kidney function and use of medications to treat high blood pressure, cholesterol and blood sugar.
Post-stroke blood glucose measurements were taken an average of two years after their first stroke; About 20 percent of study participants were taking diabetes medication before their strokes. Neither factor was associated with a faster loss of memory or executive function, which measure the ability to make complex decisions.
Levine noted that the new study suggests a need for clinical research to test whether tight glycemic control reduces post-stroke cognitive decline and dementia in stroke survivors.
Strict glycemic control has been shown to reduce complications of small blood vessels in the eyes, kidneys and nerves in people with diabetes. Tighter glycemic control may also reduce small blood vessel disease in the brain, but this is unproven.
In the meantime, people who have survived strokes and mini-strokes, also called TIAs, should work with their health care teams to determine the best way to test and manage blood sugar for them — especially if: They have pre-diabetes or diabetes. Levine notes that having blood sugar levels too low in older adults also carries risks, including dementia, and should be avoided.