Cross-sectional analysis of cognitive impairment and relative factors after acute ischemic stroke

Abstract

Background Acute ischemic stroke may decline cognitive function and induce vascular dementia (VaD). In early identification of vascular cognitive impairment (VCI), active searching for relevant factors, effective and timely treatment can reduce or even prevent further decline of cognitive function. The purpose of this study is to investigate the cognitive impairment after acute ischemic stroke and its associated factors. Methods A total of 314 cases of acute ischemic stroke patients were recruited in this study. The Montreal Cognitive Assessment (MoCA) was used to evaluate the degree of cognitive impairment. The American National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the extent of neurological deficit. The Barthel Index (BI) was used to evaluate activities of daily living. Hamilton Depression Rating Scale (HAMD) was used to evaluate the patients' mental or emotional state. Results Based on the examination results, post-stroke cognitive impairment (PSCI) group were less educated (P = 0.000) with lower BI score (P = 0.008), higher HAMD score and higher NIHSS score (P = 0.000, for all), and elevated serum high⁃sensitivity C-reactive protein (hs-CRP, P = 0.002) and glycosylated hemoglobin A1c (HbA1c) levels (P = 0.005) than those in post-stroke no cognitive impairment (PSNCI) group. In PSCI group, the concentration of serum hs-CRP and HbA1c, NIHSS and HAMD scores were negatively correlated with the MoCA rating (P < 0.05, for all); whereas, BI score was positively correlated with the MoCA rating (P < 0.05). The subjects in PSCI group had more cortical ischemic vascular disease (CIVD) and left hemisphere ischemic vascular disease (LHIVD) than subjects in PSNCI group (P < 0.05). Logistic regression analysis indicated that lower education, history of diabetes, higher HAMD score, higher serum hs-CRP and HbA1c levels were independent risk factors for PSCI. Conclusion Cognitive impairment after acute ischemic stroke may be closely related to demographic factors, serum hs-CRP level, stroke subtype, HAMD score, the extent of neurological deficit, as well as glycemic control status.