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Diabetes Mellitus and Post Stroke Cognitive Recovery After Ischaemic Stroke: A Study from Tertiary Care Centre in
Naik Ashwini1, Prabhu Arvind N1, Gorthi Sankar P1,2
1Department of Neurology, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.
Background:
Stroke is a leading cause of disability and mortality and is frequently associated with cognitive impairment. Diabetes mellitus is a common comorbidity in ischaemic stroke and is linked with poor neurological outcomes. However, longitudinal evidence comparing the burden of post-stroke cognitive impairment and cognitive recovery trajectories between patients with and without diabetes remains limited.
Purpose:
The present study compared the prevalence and severity of cognitive impairment in ischaemic stroke patients with and without diabetes mellitus at baseline and on day 90 post-stroke, and evaluated whether diabetes mellitus influences the trajectory of cognitive recovery over 90 days.
Methods:
In this longitudinal follow-up study, 401 ischaemic stroke patients (167 with diabetes mellitus and 234 without) underwent cognitive assessment using the Montreal Cognitive Assessment (MoCA) scale at baseline and at 90 days post-stroke. Between group comparisons (diabetes vs non-diabetes) were performed using appropriate parametric or non-parametric tests. Cognitive recovery trajectories were analysed using a linear mixed-effects model.
Results:
Patients with diabetes mellitus were significantly older (p = .011) and had a higher prevalence of hypertension (p < .001) and atrial fibrillation (p = .035) than those without diabetes.In the linear mixed-effects model, MoCA scores improved significantly from baseline to day 90 (β = 6.13, SE = 0.36, p < .001), indicating overall cognitive recovery. Diabetes mellitus was associated with lower MoCA scores (β = -1.36, SE = 0.74, p = .065), but the interaction between time and diabetes was not significant (p = .931), suggesting comparable cognitive recovery over time in both groups. Cognitive outcomes demonstrated significant improvement from baseline to 90 days post-stroke in both groups.
Conclusion:
Patients with diabetes demonstrated a greater burden of cognitive impairment at baseline and on day 90; however, cognitive improvement over 90 days was comparable regardless of diabetes status.