BACKGROUND Cognitive impairment is a major health concern among older and oldest people. Moreover, stroke is a relevant contributor for cognitive decline and development of dementia. The study of cognitive decline focused on stroke as the important risk factor by recruiting older and oldest is still lagging behind. Therefore, the aim of this study was to investigate the importance of stroke as a risk factor of cognitive decline during 3 years in community dwelling older and oldest people. METHODS This study was longitudinal study with a 3-year follow-up in Japan. The participants were 1333 community dwelling older and oldest people (70 years old = 675, 80 years old = 589, and 90 years old = 69). Data collected included basic data (age, sex, and history of stroke), vascular risk factors (hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and current smoking), and social factors (educational level, frequency of going outdoors, long-term care (LTC) service used, and residential area). The Japanese version of the Montreal Cognitive Assessment (MoCA-J) was decline of ≥2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between stroke and other risk factors with cognitive decline during a 3-year follow-up. RESULTS The fit of the hypothesized model by multiple logistic regression showed that a history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors that were significantly correlated with cognitive decline during the 3-year follow-up. CONCLUSIONS The cognitive decline after the 3-year follow-up was influenced by the history of stroke and advanced age, while greater MoCA-J score at the baseline was positively associated with subsequent 3 years cognitive decline. The protective factors were the presence of dyslipidemia and a higher educational level. Therefore, these factors are considered important and should be taken into consideration when searching for creative solutions to prevent cognitive decline after stroke in community dwelling older and oldest people.

中文翻译：

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SONIC研究表明，中风作为社区居民中老年人认知能力下降的危险因素的重要性。

背景技术认知障碍是老年人和老年人中的主要健康问题。此外，中风是导致认知能力下降和痴呆发展的重要因素。关于认知功能下降的研究仍以脑卒中作为重要的危险因素，因为它招募了年龄较大和年龄最大的人，但这项研究仍然落后。因此，本研究的目的是调查在社区居住的老年人中，卒中作为3年内认知能力下降的危险因素的重要性。方法本研究是一项纵向研究，在日本进行了为期3年的随访。参与者是1333个居住着老年人的老年人（70岁= 675、80岁= 589和90岁= 69）。收集的数据包括基本数据（年龄，性别和中风史），血管危险因素（高血压，糖尿病，血脂异常，心房颤动和当前吸烟）以及社会因素（教育程度，到户外活动的频率，使用的长期护理（LTC）服务以及居住区）。日文版的蒙特利尔认知评估（MoCA-J）将≥2分的下降定义为认知下降。在三年的随访中，采用多元逻辑回归分析研究中风和其他危险因素与认知能力下降之间的关系。结果多元逻辑回归对假设模型的拟合显示，卒中史，高龄和基线时较高的MoCA-J得分是重要的危险因素，而血脂异常和较高的教育水平则是保护因素。与3年随访期间的认知下降显着相关。结论3年随访后的认知能力下降受中风病史和高龄的影响，而基线时MoCA-J评分较高与随后3年的认知能力下降呈正相关。保护因素是血脂异常的存在和较高的教育水平。因此，这些因素被认为很重要，在寻找创造性的解决方案以防止居住在老年人群中的老年人中风后认知能力下降时，应考虑这些因素。