# Risk factors for post-cerebral infarction cognitive dysfunction in older adults: a retrospective study

## TL;DR

This study identifies risk factors for cognitive dysfunction after cerebral infarction in older adults, including type 2 diabetes and low direct bilirubin levels.

## Contribution

The study introduces a novel predictive model for post-cerebral infarction cognitive dysfunction using clinical and biomarker data.

## Key findings

- Rural residence, type 2 diabetes, and low direct bilirubin levels are independently associated with cognitive dysfunction after cerebral infarction.
- A predictive model using these factors shows optimal efficiency in identifying at-risk patients.
- Lower serum direct bilirubin concentration is linked to better cognitive outcomes post-infarction.

## Abstract

Our research aims to elucidate the significance of type 2 diabetes (T2D) and provides an insight into a novel risk model for post-cerebral infarction cognitive dysfunction (PCICD).

Our study recruited inpatients hospitalized with cerebral infarction in Xijing hospital, who underwent cognitive assessment of Mini-Mental State Examination (MMSE) from January 2010 to December 2021. Cognitive status was dichotomized into normal cognition and cognitive impairment. Collected data referred to Demographic Features, Clinical Diseases, scale tests, fluid biomarkers involving inflammation, coagulation function, hepatorenal function, lipid and glycemic management.

In our pooled dataset from 924 eligible patients, we included 353 in the final analysis (age range 65–91; 30.31% female). Multivariate logistic regression analysis was performed to show that Rural Areas (OR = 1.976, 95%CI = 1.111–3.515, P = 0.020), T2D (OR = 2.125, 95%CI = 1.267–3.563, P = 0.004), Direct Bilirubin (OR = 0.388, 95%CI = 0.196–0.769, P = 0.007), Severity of Dependence in terms of Barthel Index (OR = 1.708, 95%CI = 1.193–2.445, P = 0.003) that were independently associated with PCICD, constituting a model with optimal predictive efficiency.

To the best of our knowledge, this study provides a practicable map of strategical predictors to robustly identify cognitive dysfunction at risk of post-cerebral infarction for clinicians in a broad sense. Of note, our findings support that the decline in serum direct bilirubin (DBil) concentration is linked to protecting cognitive function.