Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May;40(5):e70087.
doi: 10.1002/gps.70087.

Incidence and Factors Associated With Cognitive Impairment 90 Days After First Ever Ischemic Stroke

Małgorzata Dec-Ćwiek  1 , Paweł Wrona  1 , Tomasz Homa  1 , Joanna Słowik  2 , Aleksandra Bodzioch  1 , Agnieszka Słowik  1
Affiliations

Incidence and Factors Associated With Cognitive Impairment 90 Days After First Ever Ischemic Stroke

Małgorzata Dec-Ćwiek et al. Int J Geriatr Psychiatry. 2025 May.

Abstract

Objectives: Post-stroke cognitive impairment (PSCI) is prevalent among stroke survivors, negatively impacting long-term outcomes. We aimed to assess the prevalence of PSCI and its risk factors in participants from the iBioStroke study (n = 1042), 90 days after their first ischemic stroke.

Methods: We prospectively analyzed data from 582 participants, without cognitive problems before stroke based on the structured interview with the patient, a family member or a caregiver, and/or clinical documentation (if available), who completed the Montreal Cognitive Assessment (MoCA) at discharge and 90 days post-stroke. Two MoCA cut-offs were used to define PSCI: a score of ≤ 25 in the first model and ≤ 22 in the second model. Multivariate logistic regression was employed to identify independent risk factors for PSCI based on 30 collected parameters.

Results: In the first model, PSCI was identified in 418 (71.8%) participants at day 90. Independent risk factors included older age (OR = 1.05; 95% CI:1.02-1.08), fewer years of education (OR = 0.83; 95% CI: 0.73-0.93), lower MoCA scores at discharge (OR = 0.76; 95% CI: 0.69-0.84), higher anxiety levels (HADS-A) at day 90 (OR = 1.10; 95% CI: 1.01-1.21), and larger stroke volume (OR = 1.01; 95% CI: 1.00-1.01). In the second model, PSCI was observed in 294 (50.5%) participants. Older age (OR = 1.06; 95% CI: 1.03-1.09), fewer years of education (OR = 0.87; 95% CI: 0.78-0.96), lower MoCA scores at discharge (OR = 0.83; 95% CI: 0.77-0.88), and higher depression levels (HADS-D) at day 90 (OR = 1.10; 95% CI: 1.03-1.18) were significant predictors.

Conclusions: Based on our data, PSCI seems to be a common consequence of stroke. Both irreversible factors, such as age and educational level, stroke volume, and potentially modifiable factors, including post-stroke anxiety or depression and acute cognitive impairment, contribute to PSCI risk. These findings underscore the importance of early cognitive and psychiatric interventions in stroke survivors.

Keywords: MoCA; cognitive impairment; ischemic stroke; risk factor.

PubMed Disclaimer

References

    1. E. J. Benjamin, M. J. Blaha, S. E. Chiuve, et al., “Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association,” Circulation 135, no. 10 (2017): e146–e603, https://doi.org/10.1161/cir.0000000000000485.
    1. N. S. Rost, A. Brodtmann, M. P. Pase, et al., “Post‐Stroke Cognitive Impairment and Dementia,” Circulation Research 130, no. 8 (April 2022): 1252–1271, https://doi.org/10.1161/circresaha.122.319951.
    1. J. Filler, M. K. Georgakis, and M. Dichgans, “Risk Factors for Cognitive Impairment and Dementia After Stroke: A Systematic Review and Meta‐Analysis,” Lancet Healthy Longevity 5, no. 1 (January 2024): e31–e44, https://doi.org/10.1016/s2666‐7568(23)00217‐9.
    1. O. A. Skrobot, S. E. Black, C. Chen, et al., “Progress Toward Standardized Diagnosis of Vascular Cognitive Impairment: Guidelines From the Vascular Impairment of Cognition Classification Consensus Study,” Alzheimer's and Dementia 14, no. 3 (2018): 280–292, https://doi.org/10.1016/j.jalz.2017.09.007.
    1. Z. S. Nasreddine, N. A. Phillips, V. Valérie Bédirian, et al., “The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool for Mild Cognitive Impairment,” Journal of the American Geriatrics Society 53, no. 4 (April 2005): 695–699.

Publication types

LinkOut - more resources