Serum multi-trace elements and post-stroke cognitive impairment: a prospective observational cohort study

Area of Science:

• Neurology
• Biochemistry
• Nutritional Science

Background:

• Post-stroke cognitive impairment (PSCI) is a common and debilitating condition affecting stroke survivors.
• Identifying modifiable risk factors is crucial for mitigating PSCI.
• Serum multi-trace elements are vital for neurological function but their role in PSCI is not fully understood.

Purpose of the Study:

• To investigate the association between baseline serum multi-trace element concentrations and the incidence of PSCI.
• To explore the relationship between specific multi-trace elements and different cognitive domains.
• To assess the predictive value of serum multi-trace elements for PSCI risk.

Main Methods:

• Logistic regression analyses were used to examine the association between serum multi-trace elements and PSCI.
• The Kruskal-Wallis test was employed to assess associations with specific cognitive domains.
• The Montreal Cognitive Assessment was used to define PSCI.
• Predictive ability was evaluated by assessing improvements in risk reclassification.

Main Results:

• Lower serum iron and zinc concentrations were linked to a higher risk of PSCI.
• Higher serum iron and magnesium, and lower serum copper concentrations were associated with a lower risk of PSCI.
• Serum iron influenced broader cognitive functions, while magnesium and copper were strongly linked to language and executive functions.
• Inclusion of multi-trace elements improved PSCI risk prediction.

Conclusions:

• Serum multi-trace elements, including iron, zinc, magnesium, and copper, are significantly associated with the risk and progression of PSCI.
• Specific trace elements have differential impacts on various cognitive domains.
• Monitoring and potentially modulating serum multi-trace element levels could be a viable strategy for preventing or managing PSCI in stroke survivors.