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Aug 01, 2011

Cognitive Impairment Higher in Southern Stroke Belt

Stroke belt residents more likely to have impaired memory and perception of time than rest of U.S.

Eight states including Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee make up the so-called stroke belt of the United States. This Southern region has significantly higher rates of stroke and stroke mortality than the rest of the country, in part due to greater incidence of cardiovascular risk factors such as hypertension, diabetes, kidney disease and metabolic syndrome. Since the discovery of this phenomenon in the 1950s, researchers have worked to help reduce disparities and improve the cardiovascular health of the residents.

Based on a recent study, called the REGARDS study, the stroke belt not only has higher rates of stroke but also is at increased risk for reduced brain function, known as cognitive impairment. These findings were based on data collected between 2003 and 2007 from nearly 24,000 adults, 56% of whom were stroke belt residents. During this study, participants were surveyed every two years for the evaluation of brain function, including memory and perception of time. Among study participants, stroke belt residents were 18% more likely to have impaired brain function than adults living in other parts of the United States.

This study is the first to document cognitive impairment disparities among residents of this region, which will provide useful information for researchers and healthcare providers. Based on results, researchers believe that this reduced cognitive function is a direct result of greater risk factors for stroke, like diabetes. The same risk factors for stroke also increase risk for cognitive impairment, which are more prominent in the stroke belt than other areas of the country. However, African-American race, old age, and limited education were also strongly associated with reduced cognitive function, nearly doubling risk. Therefore, stroke belt residents should work with healthcare providers to reduce risk for stroke and cognitive impairment through cardiovascular risk reduction, particularly those at greatest risk for these conditions.

Questions for You to Consider

  • What is cognitive impairment?

  • Cognitive impairment is reduced brain function associated with problems around memory, language, thinking and judgment. This condition often comes with old age, but can also occur as a result of cardiovascular risk factors or stroke.
  • Why does the stroke belt have increased cardiovascular risk?

  • There are many explanations for increased cardiovascular risk in the region, such as poor diet and reduced physical activity among residents. Race also plays a large factor, as there is a high African-American population, which is affected by heart disease and stroke more than other races.