Depression, Type 2 Diabetes, and Poststroke Cognitive Impairment.

Area of Science:

• Neurology
• Psychiatry
• Endocrinology

Background:

• Stroke survivors are at high risk for dementia and vascular cognitive impairment.
• Depression and type 2 diabetes are prevalent post-stroke and known dementia risk factors in the general population.
• The cumulative impact of these comorbidities on cognitive outcomes in stroke survivors requires further investigation.

Purpose of the Study:

• To evaluate the combined association of depressive symptoms and type 2 diabetes with cognitive outcomes in stroke survivors.
• To identify specific cognitive domains affected by these comorbidities.

Main Methods:

• A multicenter observational cohort study included 342 participants within 6 months of stroke.
• Depression screened using the Center for Epidemiological Studies Depression (CES-D) scale.
• Cognitive function assessed using the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT) parts A and B, and 5 Word Delayed Free Recall task.

Main Results:

• 32.2% had type 2 diabetes and 40.6% had depressive symptoms (CES-D ≥16).
• Comorbidities significantly increased the risk of severe cognitive impairment (MoCA <20): Odds Ratio (OR) 2.12 for one comorbidity, OR 3.18 for both.
• Executive function was significantly associated with these comorbidities, unlike processing speed or memory.

Conclusions:

• Type 2 diabetes and depressive symptoms cumulatively worsen cognitive screening outcomes post-stroke.
• Executive function deficits are particularly linked to the presence of both diabetes and depression.
• The presence of one comorbidity doubled the odds of severe cognitive impairment, while both comorbidities tripled the odds.