U.S. Southeast ‘Stroke Belt’ Also Shows Higher Rates of Cognitive Decline

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People living in an area of the southeastern United States known as the “Stroke Belt” are also at greater risk for cognitive decline, or reduced brain function, than those living in other areas, new research suggests.

The Stroke Belt states — known to have significantly higher rates of stroke deaths than the rest of the country — include Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee. According to the researchers, shared risk factors for stroke and brain impairment appear to be to blame for the greater incidence of cognitive decline in this geographic region.

The new study, published online May 26 in Annals of Neurology, followed more than 30,000 Americans aged 45 or older for a period of four years to document signs of stroke as well as cognitive decline.
In assessing reduced cognitive function, the researchers included nearly 24,000 participants (38 percent were black, and 62 percent were white) with normal brain function and no history of stroke. More than half of those participating in the study, or 56 percent, were from Stroke Belt states, while 44 percent were from other parts of the country.

After subjecting participants to brain function tests, including memory and perception of time, the researchers found that roughly 8 percent showed cognitive impairment over the course of the study period. In addition, those living in the Stroke Belt states had an 18 percent higher risk of cognitive decline than those living elsewhere in the country.

“Our study is the first to document higher incidence of cognitive impairment in the Stroke Belt compared to remaining U.S. regions,” Virginia Wadley, associate professor of medicine at the University of Alabama at Birmingham, said in a journal news release.

The study’s authors noted that more research is needed to examine other possible risk factors for reduced brain function, including migration patterns, urban versus rural living, socioeconomic status and education.

“Investigating regional patterns that contribute to modifiable risk factors affecting cognitive decline will allow for prevention and intervention efforts that are geographically concentrated,” Wadley concluded.

The study authors also suggested that their findings could help improve treatments and other services for those at greatest risk for cognitive decline.

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