Multifactoral risk factor program did not improve 7-year stroke survival

Guri Hagberg has looked at factors related to survival and cognitive outcomes seven years after stroke.


  1. No long-term effect was found on survival following a multifactoral risk factor program after stroke.
  2. Higher BMI links to improved long-term survival following stroke.
  3. Less atrophy in the medial temporal lobe one year after stroke is associated with better cognitive function six years later.


Thesis: Long term effect of stroke on survival, cognition and amyloid brain pathology – a seven-year follow-up study
Candidate: Guri Hagberg
Time: October 15, 2020 at 15:15
Place: Online-based solution, due to the covid-19 situation
Link to university website


(1) A 1-year multifactorial intervention after incident stroke or transient ischemic attack did not significantly improve survival over the next seven years. Survival was highest in the youngest patients and in patients with higher BMI, independent from other risk factors.

195 patients participated in the randomized controlled trial from 2007 to 2008, comparing an intensive risk factor intervention with usual care. Over the next seven years, 35 patients in the intervention group and 41 in the control group died.

(2) 60% of the patients who were still alive seven years after stroke had a favorable cognitive outcome, defined as normal cognitive function or mild cognitive impairment with no deterioration from 1- to 7-years follow-up. Lower age and lower medial temporal lobe atrophy at one year were independently linked to better cognitive outcomes.

Almost 60% of the surviving patients had dementia or mild cognitive impairment seven years after their first stroke. 109 patients completed the follow-up tests of cognitive function seven years after inclusion.

(3) Amyloid deposition was not common in long-term stroke survivors diagnosed with cognitive impairment. Only one of 13 patients diagnosed with cognitive impairment at 7-year follow-up had visually assessed amyloid positivity measured with Flutemetamol (18F-Flut) positron emission tomography (PET).

Furthermore, there was no correlation between the results of the PET scan at seven years and levels of amyloid-β peptide levels or measures of neurodegeneration in cerebrospinal fluid at one year.


(1) Hagberg, G., Fure, B., Sandset, E. C., Thommessen, B., Ihle-Hansen, H., Øksengård, A. R., Nygård, S., Wyller, T. B., & Ihle-Hansen, H. (2019). Long-term effects on survival after a 1-year multifactorial vascular risk factor intervention after stroke or TIA: secondary analysis of a randomized controlled trial, a 7-year follow-up study. Vascular health and risk management15, 11.

(2) Hagberg, G., Fure, B., Thommessen, B., Ihle-Hansen, H., Øksengård, A. R., Nygård, S., Pendlebury, S. T:, Beyer, M. K., Wyller, T. B., & Ihle-Hansen, H. (2019). Predictors for favorable cognitive outcome post-stroke: A-seven-year follow-up studyDementia and geriatric cognitive disorders48(1-2), 45-55.

(3) Hagberg, G., Ihle-Hansen, H., Fure, B., Thommessen, B., Ihle-Hansen, H., Øksengård, A. R., Beyer, M. K., Wyller, T. B., Müller, E. G., Pendlebury, S. T., & Selnes, P. (2020). No evidence for amyloid pathology as a key mediator of neurodegeneration post-stroke-a seven-year follow-up studyBMC neurology20, 1-11.

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