{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:45:07Z","timestamp":1791924307243,"version":"4.3.4"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:sec id=\"ab-noi240093-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Prior research suggests reduced cognitive function after transient ischemic attack (TIA). Whether this is directly related to the TIA, a function of preexisting risk factors, or prior cognitive decline remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi240093-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To study if a single, diffusion-weighted image\u2013negative, adjudicated TIA is associated with longitudinal declines in cognition, independent of preexisting risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi240093-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This was a secondary data analysis from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a population-based cohort following up 30\u202f239 Black and White participants for incident cerebrovascular events. The setting consisted of telephone cognitive assessments. Participants were individuals with first-time TIA, first-time stroke, and asymptomatic community control groups with neuroimaging used for adjudication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi240093-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>First-time TIA and stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi240093-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>\n                      Verbal fluency and memory measures administered biannually. Primary outcome was a composite standardized\n                      <jats:italic>z<\/jats:italic>\n                      score, with secondary outcomes individual test performances. Adjusted segmented regression models characterized pre-event and postevent cognition and annual cognitive change.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi240093-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Included in the study were 356 individuals with first-time TIA (mean [SD] age, 66.6 [8.7]; 188 female [53%]) and 965 individuals with first-time stroke (mean [SD] age,\u200966.8 [8.2]; 494 male [51%]). A total of 14\u202f882 individuals (mean [SD] age, 63.2 [8.6] years; 8439 female [57%]) were included in the asymptomatic control group. Overall cognitive composite before index event was lower in the stroke (\u22120.25; 95% CI, \u22120.32 to \u22120.17) than TIA (\u22120.05; 95% CI: \u22120.17 to 0.07;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.005) and asymptomatic (0; 95% CI, \u22120.03 to 0.03;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) groups. After the index event, the cognitive composite of the group with stroke significantly declined (\u22120.14; 95% CI, \u22120.21 to \u22120.07) compared with that of the group with TIA (0.01; 95% CI, \u22120.10 to 0.12;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.02) and controls (\u22120.03; 95% CI, \u22120.05 to \u22120.01;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.003). The annual decline after the index event was faster (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.001) in the group with TIA (\u22120.05; 95% CI, \u22120.06 to \u22120.03) than that for asymptomatic controls (\u22120.02; 95% CI, \u22120.02 to \u22120.02) but not different from the group with stroke (\u22120.04; 95% CI, \u22120.05 to \u22120.03;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.43).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi240093-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Results of this cohort study suggest that despite the quick resolution of stroke symptoms in TIA, there was apparently sufficient impact to be associated with long-term cognitive decline. Whether the underlying mechanisms are by direct or secondary injury and\/or interaction with concomitant neurodegenerative factors remains to be elucidated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaneurol.2024.5082","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T11:01:32Z","timestamp":1739185292000},"page":"323","source":"Crossref","is-referenced-by-count":17,"title":["Cognitive Decline After First-Time Transient Ischemic Attack"],"prefix":"10.1001","volume":"82","author":[{"given":"Victor A.","family":"Del Bene","sequence":"first","affiliation":[{"name":"Department of Neurology, The University of Alabama at Birmingham Heersink School of Medicine, Birmingham"},{"name":"The Evelyn F. 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