Memory Lapses Among Highly Educated May Signal Higher Stroke Risk

People with a high level of education who complain about memory lapses have a higher risk for stroke.

DALLAS, Dec. 11, 2014 — People with a high level of education who complain about memory lapses have a higher risk for stroke, according to new research in the American Heart Association journal Stroke.

“Studies have shown how stroke causes memory complaints,” said Arfan Ikram, M.D., associate professor of neuroepidemiology at Erasmus University Rotterdam in The Netherlands. “Given the shared underlying vascular pathology, we posed the reverse question: ‘Do memory complaints indicate an increased risk of strokes?’”

As part of the Rotterdam Study (1990-93 and 2000-01), 9,152 participants 55 or older completed a subjective memory complaints questionnaire and took the Mini-Mental State Examination (MMSE).

By 2012, 1,134 strokes occurred: 663 were ischemic, 99 hemorrhagic and 372 unspecified.

Subjective memory complaints was independently associated with a higher risk of stroke, but a higher MMSE score wasn’t.

Furthermore, those with memory complaints had a 39 percent higher risk of stroke if they also had a higher level of education. The finding is comparable to the association between subjective memory complaints and Alzheimer’s disease among highly educated people.

“Given the role of education in revealing subjective memory complaints, we investigated the same association but in three separate groups: low education, medium education and high education,” Ikram said. “We found that the association of memory complaints with stroke was strongest among people with the highest education. If in future research we can confirm this, then I would like to assess whether people who complain about changes in their memory should be considered primary targets for further risk assessment and prevention of stroke.”

Researchers categorized level of education into three groups: low education — primary education only; intermediate education – primary education plus some higher education, lower vocational education, intermediate vocational education, or general secondary education; and high education – higher vocational education or university training.

The study results apply evenly to men and women. With more than 95 percent of study participants being Caucasians living in Rotterdam, future studies should include more racially diverse groups, Ikram said.

A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures). When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it and brain cells die. According to the American Stroke Association, about 795,000 Americans had a new or recurrent stroke each year. For more about stroke risk and prevention, visit

Co-authors are Ayesha Sajjad, M.D.; Saira Saeed Mirza, M.D.; Marileen L.P. Portegies, M.D.; Michiel J. Bos, M.D., Ph.D.; Albert Hofman, M.D., Ph.D.; Peter J. Koudstaal, M.D., Ph.D.; and Henning Tiemeier, M.D., Ph.D. Author disclosures and funding information are on the manuscript.

Additional Resources:

  • Researcher photo, stroke illustrations, and animation available on the right column of the release link
  • American Stroke Association
  • Simple techniques can help memory after stroke
  • Follow AHA/ASA news on Twitter @HeartNews.
  • For stroke science, follow the Stroke journal at @StrokeAHA_ASA.


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