How far you went in school might shape your brain's ability to bounce back post-stroke, suggests new research.
Study: Cognitive Declines After a Stroke Affected This Group More Than Others
Published on May 27, 2025
Though past research has indicated that someone’s level of education could delay the onset of dementia, there’s a limit to how far book smarts can help when recovering from a stroke, suggests a new study.
Researchers from the University of Michigan—in addition to Johns Hopkins, Boston University, Ohio State University, and other universities and healthcare systems—recently sought to answer an important question: “Is level of education associated with trajectory of cognitive decline following a stroke?”
Published in March’s JAMA Network Open, their study analyzed data from four different studies that occurred between 1971 and 2019. The compilation, known as the Effect of Vascular Risk Factors on Cognitive Trajectories After Stroke study, included 2,019 participants, none of whom had dementia at the beginning.
The researchers also considered whether the participants had education levels that were:
- Less than high school
- Completed high school
- Some college
- College graduate
After the follow-up period, 1,876 individuals were determined to have had an ischemic stroke and 143 had a hemorrhagic stroke. Additionally, the participants were at least 18 years old when they experienced an acute stroke and had at least one cognitive assessment before and after their strokes.
A press release on the study confirmed “college graduates performed better on initial post-stroke examinations of global cognition, a measure of overall cognitive ability that includes mental functions like memory, attention and processing speed.”
Despite those initial results, it was determined that “attending college was associated with higher initial poststroke executive function scores but faster decline over time.”
Said Dr. Mellanie V. Springer, the study’s first author: “Our findings suggest that attending higher education may enable people to retain greater cognitive ability until a critical threshold of brain injury is reached after a stroke. At this point, compensation may fail, and rapid cognitive decline occurs.” Dr. Springer is a professor of neurology at the University of Michigan’s medical school.
Participants with “some college education” were reported to have a slower memory decline after a stroke versus those who had graduated college. Additionally, the study notes, “Survivors with a high school degree did not differ in the rate of change in memory after stroke compared with those with less than a high school degree.”
The team also found that having a “higher number” of a genetic risk factor for Alzheimer’s disease, known as ApoE4 allele, did not affect the relationship between someone’s education level and their post-stroke cognitive decline.
“Identifying which stroke patients are at the highest risk for cognitive decline will help target future interventions to slow cognitive decline,” Dr. Springer concluded.
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