Yi Donga b, Mei Cuia c, Min Fangd e, Li Gongd f, Xiuzhe Wangg h, Xiaofeng Xui j, Zhuojun Xuk l, Yue Zhangk m, Lingyun Chenn o, Xueyuan Liup q, Gang Li
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Background: Post-stroke cognitive impairment (PSCI) or post-stroke dementia (PSD) may affect one third of stroke patients. Understanding the risk factors related to the development of PSCI or PSD in acute stroke may help prevent and treat PSCI or PSD. A large-scale examination of PSCI risk factors was done for the first time in Shanghai stroke population Method: This was a multicenter observational registry study. The inclusion criteria were: >18-year-old, had an ischemic stroke within 2 weeks. Those with preexisting cognitive impairment, language, impaired hearing or reading or without education were excluded. Once informed consents signed, MOCA, mini-MOCA and MMSE were completed. Rate of PSCI and its related risk factors were examined. Statistical analysis was conducted by STATA 15. Logistic regression was performed to evaluate the risk factors and their odds ratios. Results: Of 1006 AIS patients with stroke onset within 14 days, 516 (51.8%, 95% CI 46.3-58.2%) had PSCI. These patients performed poorly in MOCA spatial, naming, registration, abstraction, language, orientation and short-term memory tests. Multiple regression model showed that patients with advance aging (OR 1.846 95%CI 1.806-2.826), severe stroke (OR 2.182, 95%CI 1.296-3.273), previous stroke history (OR 1.507, 95%CI 1.053-2.057) were likely to develop PSCI in acute phase of ischemic stroke. However, high level of education (OR 0.374, 95%CI 0.273-0.589) and LDL level>1.8 mmol/L may relate to the less PSCI rate in post stroke patients (OR 0.499, 95%CI 0.279-0.892). There is no significant correlation between stroke type and PSCI. Conclusion: In this post-stroke cognitive study cohort, PSCI was common among stroke patients in Shanghai. The risk factors of PSCI are age, previous stroke and less educated, however, the strategy of how to prevent PSCI is still unknown. The paradoxical phenomenon of protective effect of hyperlipidemia in PSCI remains to be further studied.
