title: Executive dysfunction is a strong stroke predictor.
abstract: BACKGROUND
  Although stroke is known to result in executive dysfunction, little is known about executive dysfunction as a risk factor for stroke.
  
  
  METHODS
  Canadian Study of Health and Aging (CSHA), a longitudinal population based study of elderly Canadians, was conducted in three waves in 1990-1991 (CSHA-1), 1995-1996 (CSHA-2), and 2001-2002 (CSHA-3). In a cross-sectional analysis on CSHA-1 subjects, any association between stroke history and cognitive function was studied. In a prospective analysis, CSHA-1 stroke-free subjects were followed to CSHA-2 to see if there was any difference in stroke incidence among subjects with different baseline cognitive status. And, in a validation study CSHA-2 stroke-free subjects were followed to CSHA-3 to see if the prospective analyses findings could be replicated.
  
  
  RESULTS
  In the cross-sectional analysis, subjects who had stroke in their history had significantly lower executive function, not memory function, scores than subjects without any stroke in their history. In the prospective and validation studies, stroke incidence was affected by neither executive nor memory scores. When the analysis was restricted to normal cognition subjects, lower executive function, not memory function, scores predicted stroke incidence, and remained significant after controlling for stroke risk factors.
  
  
  CONCLUSIONS
  We found executive dysfunction to be a powerful stroke risk factor among cognitively normal subjects. Testing for executive dysfunction may help identify individuals at risk for stroke in time to prevent them.
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States; Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: shahram_oveisgharan@rush.edu.
authors.forename: Shahram
authors.initials: S
authors.lastname: Oveisgharan
authors.affiliation: Department of Clinical Neurological Sciences, University Hospital, University of Western Ontario, London, ON, Canada.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Hachinski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D002170:Canada / Q000453:epidemiology; D003071:Cognition; D003430:Cross-Sectional Studies; D003704:Dementia / Q000209:etiology; D056344:Executive Function; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*
keywords: Dementia; Executive function; Longitudinal study; Memory; Risk factors; Stroke