Determinants of post-stroke cognitive impairment: analysis from VISTA

Area of Science:

• Neurology
• Cognitive Science
• Epidemiology

Background:

• Post-stroke cognitive impairment (PSCI) is a common complication following stroke.
• PSCI is associated with an increased risk of developing dementia.
• Understanding predictors of PSCI is crucial for patient outcomes.

Purpose of the Study:

• To investigate the relationship between demographic, clinical, and stroke symptoms at onset and PSCI.
• To identify early indicators of cognitive decline after stroke.
• To assess PSCI at 1 and 3 years post-stroke.

Main Methods:

• Utilized anonymized data from the Virtual International Stroke Trial Archive (VISTA).
• Defined PSCI using the Mini-Mental State Examination (MMSE) score of ≤26.
• Employed logistic regression to analyze associations between baseline symptoms and PSCI, adjusting for covariates.

Main Results:

• Analyzed data from 5435 patients; 34% had PSCI at 1 year and 30% at 3 years.
• Initial leg paralysis was significantly associated with increased PSCI rates at both 1 year (OR=1.62) and 3 years (OR=1.95).
• Findings were consistent in subgroup analyses, including ischemic stroke and transient ischemic attack.

Conclusions:

• Age, stroke severity, and vascular risk factors are known determinants of PSCI.
• Leg paralysis emerges as an additional, significant predictor of subsequent PSCI.
• Early identification of leg paralysis may aid in predicting long-term cognitive outcomes.