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59/100

✓ Peer-reviewed alzhub usefulness score 59 out of 100. Risk factors

Topic: Amyloid, tau and blood-test diagnosis

Background Alzheimer disease (AD) and stroke are common in elderly individuals, but the relation between these 2 disorders remains uncertain. Objective To investigate the association between a clinical history of stroke and subsequent risk of AD. Design A cohort of 1766 Medicare recipients without dementia participated in a longitudinal follow-up study from 1992 through 1999 in upper Manhattan, New York, NY. History of stroke and presence of cardiovascular risk factors were ascertained at the onset of the study. Incidence rates for AD among those with and without stroke were calculated; proportional hazards ratios were computed using age at onset of the disease as the time-to-event variable. Results The annual incidence for AD was 5.2% among individuals with stroke vs 4% for those without stroke. The hazards ratio for AD among those with a history of stroke was 1.6 (95% confidence interval, 1.0-2.4) compared with those without stroke. Of the vascular risk factors, hypertension, diabetes, and heart disease, only diabetes related to risk of AD in the absence of stroke. Stroke remained weakly associated with AD in the absence of these factors, but risk significantly increased with the additional factors of hypertension (relative risk, 2.3; 95% confidence interval, 1.4-3.6), diabetes (relative risk, 4.6; 95% confidence interval, 2.2-9.5), or heart disease (relative risk, 2.0; 95% confidence interval, 1.2-3.2). Conclusions Stroke is associated with AD among elderly individuals. The relation is strongest in the presence of known vascular risk factors. The observed association between stroke and AD might relate to an underlying systemic vascular disease process, or alternatively, to the additive effects of stroke and AD pathologic features, leading to an earlier age at onset of disease.

Key findings

Results The annual incidence for AD was 5.2% among individuals with stroke vs 4% for those without stroke.
The hazards ratio for AD among those with a history of stroke was 1.6 (95% confidence interval, 1.0-2.4) compared with those without stroke.
Stroke remained weakly associated with AD in the absence of these factors, but risk significantly increased with the additional factors of hypertension (relative risk, 2.3; 95% confidence interval, 1.4-3.6), diabetes (relative risk, 4.6; 95% confidence interval, 2.2-9.5), or heart disease (relative risk, 2.0; 95% confidence interval, 1.2-3.2).
Conclusions Stroke is associated with AD among elderly individuals.

Why it matters

In this longitudinal study of 1,766 Medicare recipients without dementia, a history of stroke was associated with a higher risk of Alzheimer's disease, and risk increased further when hypertension, diabetes, or heart disease were also present. This shows stroke and vascular risk factors are linked to Alzheimer's disease risk, but does not show that preventing stroke cures or prevents Alzheimer's disease.

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Study details

Study designlongitudinal study
Effect size5.2%
Evidence strengthModerate

How this study scored 59/100

Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Archives of neurology)
Journal's citation record	3 / 4	Archives of Neurology: journal h-index 353 (OpenAlex, 2026-10-29)
Study design	7 / 12	A longitudinal study following the same people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2003 — older than 20 years, still counted
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	0 / 3	Not stated whether this was studied in people — scores zero (not stated in the record — scored 0)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	6 / 7	Cited 343 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	13.7 citations a year over 25 year(s) since 2003
Impact for its field and year	4 / 6	Cited 12.1× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	3 / 6	Cited by 27 other studies in this library
Still being cited	2 / 4	Cited 24 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	4 / 4	Last-listed author Richard P Mayeux: h-index 158 (OpenAlex, whole career)
Institution's track record	2 / 3	Columbia University: institution h-index 1,824 (OpenAlex)
Multi-centre collaboration	0 / 3	OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete)
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 14676044)
Free to read	0 / 2	Behind a paywall — scores zero
Total	59 / 100	—

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Read the original

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.

APA 7th

Honig, L. S., Tang, M. X., Albert, S., Costa, R., Luchsinger, J., Manly, J., et al. (2003). Stroke and the risk of Alzheimer disease. Archives of neurology. https://doi.org/10.1001/archneur.60.12.1707

Vancouver

Honig LS, Tang MX, Albert S, Costa R, Luchsinger J, Manly J, et al. Stroke and the risk of Alzheimer disease. Archives of neurology. 2003. doi:10.1001/archneur.60.12.1707. PMID: 14676044.

BibTeX

@article{honig2003-14676044,
  author  = {Honig, L. S. and Tang, M. X. and Albert, S. and Costa, R. and Luchsinger, J. and Manly, J. and Stern, Y. and Mayeux, R.},
  title   = {{Stroke and the risk of Alzheimer disease}},
  journal = {Archives of neurology},
  year    = {2003},
  doi     = {10.1001/archneur.60.12.1707},
  pmid    = {14676044},
  url     = {https://doi.org/10.1001/archneur.60.12.1707}
}

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