The dynamics of post-stroke cognitive impairment in patients with different metabolic profiles

Abstract

Study purpose . To assess the dynamics of cognitive status during the recovery period following ischemic stroke (IS) in patients with different metabolic statuses and to identify predictors of the development and progression of cognitive impairment (CI) in a group of patients with metabolic syndrome (MS). Material and methods . 237 patients diagnosed with ischemic stroke on the 21st day and 12 months after the onset of IS were examined. The patients were divided into two groups: group 1 — 115 patients with MS; group 2 — 122 patients without MS. The Clinical Dementia Rating Scale (CDR) was used to assess CI. The relationship (correlation coefficient (r), machine learning methods (information gain, i.g.)) between the CDR score and demographic, functional and laboratory parameters, IS characteristics, the presence of premorbid CI (IQCODE questionnaire), body mass index (BMI) and degree of compliance (MMAS-8 scale) was analyzed. Results . Twelve months after the onset of IS, a higher percent of patients with dementia was identified in group 1 (72.15%) compared to group 2 (34.51%). A correlation was found between the CDR index and LDL level (r = 0.397, i.g. = 0.346), IQCODE (r = 0.515, i.g. = 0.115), the number of metabolic factors (r = 0.468, i.g. = 0.411), MMAS-8 (r = -0.622, i.g. = 0.373), MS phenotypes: ‘hyperlipoproteinemia / hyperglycemia / obesity’, ‘hyperlipoproteinemia / arterial hypertension / obesity’ and full-factor intersection of metabolic factors in combination with the degree of IQCODE, MMAS-8 (i.g. = 0.216, i.g. = 0.221, i.g. = 0.301). Conclusion . Dysmetabolic disorders, both individually and in the context of MS, combined with low compliance, prestroke cognitive impairment, and age, contribute to a significant deterioration in CI during the recovery period of IS.