Post-stroke cognitive impairment was prevalent among 10-year stroke survivors, and the odds of having severe cognitive impairment were higher among the stroke survivors compared to non-stroke persons. The burden of long-term PSCI might have been underestimated previously, and MoCA may be more suitable than MMSE to detect long-term PSCI.

Background-Epidemiological studies indicate a genetic contribution to ischemic stroke risk, but specific genetic variants remain unknown, with the exception of a few rare variants. Recent genome-wide association studies identified and replicated common genetic variants on chromosome 9p21 to confer risk of coronary heart disease. We examined whether these variants are associated with ischemic stroke. Methods and Results-We genotyped 6 common genetic variants on chromosome 9p21, previously associated with coronary artery disease in genome-wide association studies, in 2 population-based studies in southern Sweden, the Lund Stroke Register (nϭ1837 cases, 947 controls) and the Malmö Diet and Cancer study (MDC; nϭ888 cases, 893 controls). We examined association in each study and in the pooled dataset. Adjustments were made for cardiovascular risk factors and further for previous myocardial infarction in MDC. We found a modest increase in ischemic stroke risk for 2 common (minor allele frequencies 0.46 to 0.49) variants, rs2383207 (Pϭ0.04 in Lund Stroke Register, Pϭ0.01 in MDC) and rs10757274 (Pϭ0.03 in Lund Stroke Register, Pϭ0.03 in MDC), in each sample independently. The strength of the association increased when samples were pooled with an odds ratio of 1.15 (95% CI, 1.05 to 1.25; Pϭ0.002) for the strongest variant rs2383207. Results were similar after adjustment for clinical covariates. rs1333049 also showed significant association in MDC, which increased in the pooled sample (Pϭ0.004). Conclusions-In this large sample (nϭ4565), we detected common genetic determinants for ischemic stroke on chromosome 9p21. Our findings indicate that ischemic stroke shares pathophysiological determinants with coronary heart disease and other arterial diseases and highlight the need for large sample sizes in stroke genetics. (Circ Cardiovasc Genet. 2009;2:159-164.)Key Words: genetics Ⅲ atherosclerosis Ⅲ cardiovascular diseases Ⅲ cerebral infarction Ⅲ stroke I schemic stroke is a leading cause of death and disability worldwide. Family and twin studies have established a genetic contribution to ischemic stroke but, with the exception of a small number of rare, monogenic disorders manifesting as ischemic stroke, few if any genetic variants have been irrefutably associated with stroke. 1 Common diseases have been hypothesized to result from common genetic variants with individually modest impact on disease risk. 2 Consequently, large sample sizes are necessary to detect or exclude association 3 as has been shown in association studies for other complex diseases, including myocardial infarction 4 and type 2 diabetes. 5 The typical odds ratios (ORs) of common genetic variants seen in these studies have been in the range of 1.1 to 1.5, necessitating sample sizes of several thousand individuals for adequate statistical power. 6 Calls for larger studies of ischemic stroke genetics have also been raised with a published power calculation for ischemic stroke suggesting that sample sizes in the range of 2444 to 4587 individuals are necessary ...