Teens With Lower Mental Abilities Face Higher Risk of Stroke

Researchers compared IQ scores of 18- to 20-year-olds to incidences of stroke years later and found that those with lower scores had a significantly higher risk of experiencing a stroke before age 50.

Recent reports estimate that deaths from stroke are expected to reach nearly 5 million in 2030. While most people who experience a stroke are older adults, the rate of this potentially deadly health condition among younger people is rising.

According to the American Heart Association (AHA), stroke hospitalizations among younger adults increased by nearly 50% from 2007 to 2017. Moreover, data shows that cases of a specific type of stroke called intracerebral hemorrhage are rising among young to middle-aged adults, up by 11% over the past 15 years.

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The rising prevalence of risk factors for stroke, such as obesity and diabetes, among young adults may be contributing to this increase. However, lower cognitive functioning can be another factor, as research suggests that people with cognitive impairment have a higher risk of experiencing a stroke.

Now, new research found more evidence that IQ may be linked to stroke risks. Specifically, scientists revealed that lower levels of mental ability measured during the late teens and early 20s may triple the risk of stroke before age 50, even after the researchers adjusted for risk factors like diabetes.

The study, published on June 27 in the Journal of Epidemiology & Community Health, assessed the cognitive ability of over 1.7 million 18- to 20-year-old men and women in Israel from 1987 to 2012. They retrieved mental ability testing data from mandatory military service evaluations, which assess a wide range of health and mental factors.

Test results revealed that 12% scored high (IQ score above 118), 70% scored medium (IQ score range of 89 to 118), and 18% ranked low (IQ score below 89) in mental ability. Individuals who scored low were more likely to have obesity or live in a socioeconomically disadvantaged community and less likely to have completed secondary education.

After the researchers linked the results of these cognitive tests to the Israeli national stroke database, they found that individuals with low mental ability were over 2.5 times more likely to experience a stroke before age 50 than those with high IQs. Moreover, individuals with medium-level cognitive ability were 78% more likely to have a stroke before age 50.

More cases of ischemic stroke (stroke caused by blood clots) occurred than intracerebral hemorrhage, with 41% of ischemic strokes occurring before the age of 40. In addition, after the researchers adjusted for factors that could skew the results, they found that ischemic stroke risk was 96% higher among individuals with a medium level IQ and over three times higher among those with low cognitive ability.

These associations remained even after the team factored in diabetes status and limited the age of an initial stroke up to 40 years old.

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How does mental ability influence stroke risks?

The reasons behind the link between higher stroke risks and lower mental ability are unclear. However, the study's authors suggest that higher cognitive function is associated with a lower likelihood of being a current smoker, higher physical activity levels, and consuming a healthier diet. These factors are linked to a lower risk of cardiovascular disease.

Despite the startling results, the study was observational, and the scientists did not have data on the participants' lifestyle factors, such as diet, physical activity, and smoking status. Nonetheless, the team believes their findings could be generalized to people in other regions of the world, including the United States.

"The robust association between lower cognitive performance in adolescence and an increased risk of early-onset stroke underscores the need for comprehensive assessments beyond traditional stroke risk factors," the study's authors wrote. "The insights from our study suggest that cognitive performance might aid in identifying individuals at higher stroke risk, thus facilitating timely interventions to address potential mediators such as health illiteracy, education, and health behaviors."

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