# Analysis of cognitive function trajectories and influencing factors in elderly patients with ischemic stroke: a prospective longitudinal study

## TL;DR

This study identifies three distinct cognitive decline patterns in elderly Chinese patients after ischemic stroke and finds factors that predict these patterns.

## Contribution

The study reveals novel cognitive trajectory subgroups and their predictors in elderly Chinese ischemic stroke patients.

## Key findings

- Three cognitive trajectory groups were identified: high-slow decline, low-intermediate decline, and low-rapid decline.
- Age, temporal lobe infarction, and serum homocysteine levels significantly predicted cognitive decline patterns.
- Tailored interventions based on cognitive trajectories may improve outcomes and quality of life in stroke patients.

## Abstract

Accurately defining cognitive function trajectories in elderly ischemic stroke patients is crucial for identifying high-risk groups for cognitive decline, enabling timely personalized interventions to improve long-term outcomes and reduce familial and societal burdens. However, research on the heterogeneity of cognitive trajectories and their underlying causes in elderly Chinese patients with ischemic stroke remains limited. This prospective longitudinal study aimed to detect unique trends in cognitive trajectories among these patients and assess the contributing factors.

Validated assessment tools were utilized to systematically evaluate cognitive function at various specified intervals. Latent variable growth models were employed to delineate distinct subgroups of cognitive trajectories and to assess the predictive relevance of baseline pathophysiological markers and influencing factors in distinguishing these trajectories.

Cognitive trajectories were categorized into three latent groups: the High Cognitive Function-Slow Decline Group (51%), the Low Cognitive Function-Intermediate Decline Group (34%), and the Low Cognitive Function-Rapid Decline Group (15%). Logistic regression analysis revealed that age, temporal lobe infarction, serum homocysteine levels, National Institutes of Health Stroke Scale score, and Multidimensional Perceived Social Support Scale score, were significant predictors of cognitive function (p < 0.05).

Geriatric patients with ischemic stroke have a gradual decline in cognitive function over time. Cognitive change trajectories can be categorized into three latent groups: High Cognitive Function-Slow Decline Group, Low Cognitive Function-Intermediate Decline Group, and Low Cognitive Function-Rapid Decline Group. Healthcare practitioners can develop tailored intervention strategies based on individual patients’ cognitive trajectories and influencing factors to reduce cognitive decline and improve quality of life.