Predictors for vascular cognitive impairment in stroke patients

Abstract

Background: Around two thirds stroke patients may suffer from vascular cognitive impairment (VCI). Our previous study has validated the NINDS-CSN harmonization standard for VCI diagnosis in Chinese. In this study, we aimed to investigate the predictors for VCI in Chinese post-stroke patients. Methods: We compared epidemiological, clinical, and neuroimaging data (number, size and location of acute infarcts and lacunes, severities of white matter hyperintensities and brain atrophy) between stroke patients with and without VCI. Univariate and logistic regression analyses were utilized to determine VCI predictors. Results: Fifty-six consecutive patients (age, 63.8±8.3 years; female, 37.5 %) were recruited at a mean interval of 7.1 months after stroke onset, and 31 (55.4 %) patients were diagnosed with VCI based on a validated 60-min neuropsychological battery. VCI patients were older (p=0.023), less educated (p=0.001), more likely to be female (p<0.001), had a recurrent stroke (p=0.028), and described higher apathy (p=0.022) and worse pre-stroke cognition (p=0.048) than cognitively normal patients. Lower educational level (adjusted odds ratio [OR] 0.750, 95 % confidence interval [CI], 0.573-0.981; p=0.035), female sex (adjusted OR 8.288, 95 % CI, 1.522-45.113; p=0.014), recurrent stroke (adjusted OR 11.327, 95 % CI, 1.335-96.130, p=0.026), and global cortical atrophy (adjusted OR 5.730, 95 % CI, 1.128-29.101, p=0.035) were independently associated with VCI in post-stroke patients. Conclusions: Lower education, female sex, recurrent stroke and global cortical atrophy were associated with VCI in Chinese stroke patients.