To investigate the association between ischemic stroke severity and cognitive decline, emphasizing its significance for dementia risk.
Key Findings:
Patients with minor stroke had nearly twice the likelihood of dementia; mild to moderate stroke had over three times; moderate to severe stroke had about five times the likelihood compared to those without stroke. The cognitive decline rates suggest that patients with mild to moderate stroke declined as if they were 1.8 years older at baseline, and those with moderate to severe stroke as if they were 2.6 years older.
Annual decline in global cognition increased with stroke severity: -0.18 points (no stroke), -0.36 points (minor), -0.47 points (mild to moderate), -0.58 points (moderate to severe).
Executive function declined faster than global cognition or memory, with a decline rate of -0.33 points per year among patients without stroke.
Interpretation:
The study suggests a graded association between ischemic stroke severity and cognitive decline, with higher severity linked to increased dementia risk.
Missing NIHSS data for nearly 30% of first-ever ischemic strokes may lead to underestimation of cognitive decline.
Exclusion of dementia diagnosed within 1 year post-stroke may have led to underestimation of poststroke dementia burden, potentially omitting common early poststroke cognitive changes.
Conclusion:
The findings support the association between more severe ischemic stroke and greater long-term cognitive risk, emphasizing the need for prevention strategies and cognitive monitoring post-stroke.
