Stroke: Effect of past cognitive impairment on clinical severity in patients with ischemic stroke

The continuing aging of the population is associated with an increasing number of stroke patients with cognitive impairmentIn a recent study published in the journal Stroke, an authoritative journal on cardiovascular disease, researchers aim to assess the clinical severity of patients with ischemic stroke based on their pre-stroke cognitive statusresearchers used population-based registration centers (2013-2017) to proactively identify patients with ischemic stroke in the population of Dijon, France, who recorded the subjects' pre-stroke cognitive status (barrier-free, mild cognitive impairment (MCI) or dementia), and used the National Institutes of Health Stroke Scale (NIHSS) score to assess cognitive severity at strokeThe researchers used a sequential regression analysis model to assess the association between pre-stroke cognitive state and severity, and used the NIHSS score as a classification variablein 1048 patients (average age of 76.3 to 15.2 years; 54.0% female), MCI patients (n-132; NIHSS median 6; quartile spacing 2-15) and dementia patients (n?164; median NIHSS is 7; quart spacing is 3-16) is higher than in patients without cognitive impairment (n?752; median NIHSS is 3; quart spacing is 1-9)Both MCI (ratio ratio of 1.70 (95% CI is 1.21-2.38) ;P and dementia (OR 2.24 (95% CI 1.65-3.04) ;P 0.001) were associated with higher severity at the time of onsetCorrelation was observed after adjusting clinical variables and near-end arterial infarct (or for MCI was 1.52 (95% CI is 1.02-2.28) ;P .04; for dementia OR 2.16 (95% CI 1.45-3.22) ;P 0.001)Further adjustment of pre-stroke disability slightly reduces the strength of the association (for MCI or 1.49 (95% CI is 0.98-2.25) ;P s 0.06, or 1.98 for dementia (95% CI is 1.26-3.12) ;P s 0.02)The higher severity of people with pre-stroke cognitive impairment is not due to more severe disorders of motor or speech functionshows that people with previous cognitive impairments are more likely to have more severe ischemic strokesThese results may reflect a reduced brain tolerance to acute ischemic schemingFurther research is needed to explore the potential mechanisms of nerve protection