Analysis of Risk Factors for Vascular Cognitive Impairment in Patients with Cerebral Infarction

An, Xiaolei; Li, Chuanling

doi:10.1007/s12013-014-0246-4

Cited by 7 publications

(8 citation statements)

References 38 publications

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“…Similarly, a review of PSD revealed that age ≥ 65 years was a risk factor for PSD (4).To determine whether there is an age-dependent association between Hcy and cognitive impairment in stroke survivors, we divided the total group into two subgroups, ≥65 and <65 years. As mentioned earlier, an independent association has been reported between Hcy and PSCI with a variable time of outcome assessments from 2 months and up to 3 years after stroke (12)(13)(14). We observed an age difference in the relationship between Hcy levels and cognitive impairment in the post-stroke population.…”

Section: Discussionsupporting

confidence: 74%

“…In our study, we also found that moderately raised Hcy (≥12 µmol/L in the total group and >8 µmol/L in the younger age group) increased the risk of cognitive impairment in the post-stroke population, which has not been studied yet. Previous studies only considered Hcy as a continuous variable in analysis and did not explore the graded association between Hcy and PSCI (12)(13)(14). The reference values for plasma Hcy ranged from 5 to 15 µmol/L.…”

Section: Discussionmentioning

confidence: 99%

“…A growing body of evidence suggests that high Hcy levels may contribute to the pathogenesis of PSCI via oxidative stress (8), vascular inflammation (8), endothelial dysfunction (9, 10), and accelerate amyloid and tau protein accumulation (11). However, clinical studies investigating the association between Hcy levels and cognitive impairment in patients with stroke have yielded inconsistent results (12)(13)(14)(15)(16). The reasons for the contradictory results of previous studies remain equivocal.…”

Section: Introductionmentioning

confidence: 99%

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Age-Dependent Association Between Elevated Homocysteine and Cognitive Impairment in a Post-stroke Population: A Prospective Study

et al. 2021

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Background and Purpose: The results regarding the independent association between homocysteine (Hcy) levels and post-stroke cognitive impairment (PSCI) were inconsistent. The effect of age on this association has yet to be explored. This study aims to determine the relationship between Hcy levels, age, and cognitive impairment in a post-stroke population.Methods: A total of 592 patients with acute ischemic stroke (AIS) completed follow-up. Serum Hcy levels were measured enzymatically by spectrophotometry within 24 h of admission. Cognitive function was evaluated by the Mini-Mental State Examination (MMSE) 1 month after stroke, and the scores ≤ 24 were considered as cognitive impairment. Our study was dichotomized into two groups by a cut-off of 65 years. Multivariate logistic regression models were used to determine the association between baseline Hcy levels and cognitive impairment.Results: According to the MMSE score, 317 (53.5%) patients had cognitive impairment. Patients with higher levels of Hcy were more prone to have cognitive impairment 1 month after stroke than patients with lower levels of Hcy (p < 0.001). The optimal cut-off points of Hcy level (μmol/L) were (T1) ≤ 8, (T2) 8–12, and (T3) ≥ 12. After adjusting for confounding factors, the multivariate regression analysis showed that the third Hcy tertile was independently associated with cognitive impairment [odds ratio (OR) = 2.057, 95% confidence interval (CI) = 1.133–3.735, p = 0.018). A stronger association [T2 (OR = 2.266, 95% CI = 1.042–4.926, p = 0.039); T3 (OR =3.583, 95% CI = 1.456–8.818, p = 0.005)] was found in the younger group. However, the independent association was not confirmed in the older group.Conclusions: Elevated Hcy levels in the acute phase of ischemic stroke were independently associated with cognitive impairment in a post-stroke population. Furthermore, the association was age-dependent and more meaningful in a younger population aged below 65. So, Hcy levels in patients with stroke should be well-monitored, especially in younger patients.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Age-Dependent Association Between Elevated Homocysteine and Cognitive Impairment in a Post-stroke Population: A Prospective Study

et al. 2021

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“…The cognitive impairment might be induced by an elevated Hcy level, which is caused by cerebrovascular disease or increased cortical or hippocampal atrophy. Hcy was reported to be a risk factor for vascular cognitive impairment in patients with cerebral infarction, and also an independent risk factor for MCI in the Xinjiang Uygur population [33,34]. It has been shown that high UA levels might be a risk factor for stroke, and the elevated level of UA was correlated with poor prognosis of stroke [35].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Values of Serum Levels of Homocysteine and Uric Acid for Predicting Vascular Mild Cognitive Impairment in Patients with Cerebral Small Vessel Disease

et al. 2017

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BackgroundThis study aimed to investigate the diagnostic values of serum levels of Hcy and UA for predicting vascular mild cognitive impairment (VMCI) in patients with cerebral small vessel disease (SVD).Material/MethodWe selected 172 cerebral SVD patients and divided them into a VMCI group and a non-VMCI group. Eighty-six healthy individuals without nervous system diseases were selected as the control group. Enzymatic cycling method was performed to detect serum Hcy and UA levels. Serum levels of folic acid (FOA) and vitamin B12 (VitB12) were detected by chemiluminescence immunoassay. Montreal cognitive assessment (MoCA) was applied to evaluate the cognitive function. The ROC curve was used to evaluate the diagnostic values of serum Hcy and UA levels for predicting VMCI. Logistic regression analysis was used to determine the possible risk factors.ResultsCompared with the non-VMCI and control groups, serum FOA and VitB12 levels were lower and serum Hcy and UA levels were higher in the VMCI group. AUC values of serum Hcy and UA levels were 0.703 and 0.829, respectively. Serum Hcy and UA levels were negatively correlated with serum FOA and VitB12 levels, total MoCA score, and subscores on visuospatial ability and executive function, on language ability and on delayed recall, and they were positively correlated with serum cholesterol (CH) level. Serum Hcy and UA levels were indicated as risk factors for VMCI in cerebral SVD patients.ConclusionsThese results suggest that serum Hcy and UA levels may serve as predictive factors for VMCI in cerebral SVD patients.

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“…All patients who agreed to participate in our research were arranged with a special nursing process post cerebral infarction. The Montreal Cognitive Assessment (MoCA) was used to evaluate the patients' cognitive function [17], by staff who was blind to the study design. The maximum score of the MoCA test is 30.…”

Section: Patientsmentioning

confidence: 99%

Serum Uric Acid and High-Sensitivity C-Reactive Protein as Predictors of Cognitive Impairment in Patients with Cerebral Infarction

Fang

Liu

Zhang

et al. 2020

Dement Geriatr Cogn Disord

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Background: Cognitive impairment induced by cerebral infarction has become a devastating health problem. More efficient predictors are required to evaluate the potential cognitive decline after cerebral infarction in clinic. Serum uric acid (UA) and high-sensitivity C-reactive protein (hs-CRP) are two factors reported to correlate with cognitive impairment. However, the understanding on serum UA and hs-CRP with cognitive dysfunction remains unclear. Methods: Serum UA and hs-CRP were evaluated in patients with cerebral infarction (n = 197) using single factor analysis and multivariate logistic regression analysis. Clinical and pathological characteristics were analyzed by logistic regression, respectively, and the results demonstrated the correlation between the pathological characteristics and the cognitive impairment post cerebral infarction. Montreal Cognitive Assessment (MoCA) was used to evaluate the patients’ cognitive function, and patients with a MoCA score <26 were recognized as with cognitive impairment. Results: Clinical characteristics related to cognitive impairment, including age, gender, blood pressure, serum UA, and hs-CRP were collected and analyzed. Serum UA and hs-CRP were identified to be potential predictors for post-stroke cognitive dysfunction, with higher serum UA levels correlated with better cognitive function and higher hs-CRP levels correlated with worse cognitive impairment. Conclusion: Serum UA and hs-CRP are two predictors for cognitive impairment post cerebral infarction.

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Analysis of Risk Factors for Vascular Cognitive Impairment in Patients with Cerebral Infarction

Cited by 7 publications

References 38 publications

Age-Dependent Association Between Elevated Homocysteine and Cognitive Impairment in a Post-stroke Population: A Prospective Study

Age-Dependent Association Between Elevated Homocysteine and Cognitive Impairment in a Post-stroke Population: A Prospective Study

Diagnostic Values of Serum Levels of Homocysteine and Uric Acid for Predicting Vascular Mild Cognitive Impairment in Patients with Cerebral Small Vessel Disease

Serum Uric Acid and High-Sensitivity C-Reactive Protein as Predictors of Cognitive Impairment in Patients with Cerebral Infarction

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