Determinants of Post-Stroke Cognitive Impairment After Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

IF 3.2 3区医学 Q2 Medicine

Neuropsychiatric Disease and Treatment Pub Date : 2026-07-09 eCollection Date: 2026-01-01 DOI:10.2147/NDT.S608599

Fangjia Shen, Xijuan Guo

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引用次数: 0

Abstract

Background: Acute ischemic stroke (AIS) is frequently complicated by post-stroke cognitive impairment (PSCI), which significantly affects long-term prognosis and quality of life. However, the evidence regarding its risk factors remains inconsistent.

Methods: A systematic search was conducted in PubMed, Embase, Cochrane Library, and Web of Science up to December 30, 2025. Observational studies evaluating risk factors for PSCI after AIS were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models. Heterogeneity, sensitivity analyses, and publication bias were assessed.

Results: Fifteen studies involving 30,022 participants were included. Age >75 years (OR = 1.07, 95% CI: 1.04-1.10), female sex (OR = 1.72, 95% CI: 1.41-2.10), diabetes (OR = 1.76, 95% CI: 1.29-2.40), elevated C-reactive protein (CRP; OR = 1.36, 95% CI: 1.14-1.62), and lower educational level (OR = 1.24, 95% CI: 1.12-1.38) were significantly associated with an increased risk of PSCI after AIS. Substantial heterogeneity was observed for some predictors, particularly age (I² = 89.9%) and educational level (I² = 89.6%).

Conclusion: Several factors, including advanced age, female sex, diabetes, elevated CRP, and lower educational level, were associated with an increased risk of PSCI after AIS. These findings may support risk stratification and early monitoring strategies. However, the substantial heterogeneity observed for some predictors should be considered when interpreting the pooled estimates. Further prospective studies are needed to confirm these associations and clarify causal relationships.

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急性缺血性脑卒中后认知障碍的决定因素：一项系统综述和荟萃分析。

背景：急性缺血性卒中（AIS）常并发卒中后认知障碍（PSCI），严重影响患者的远期预后和生活质量。然而，关于其危险因素的证据仍然不一致。方法：系统检索截至2025年12月30日的PubMed、Embase、Cochrane Library和Web of Science。纳入了评估AIS后PSCI危险因素的观察性研究。使用固定效应或随机效应模型计算95%置信区间（ci）的合并优势比（ORs）。评估异质性、敏感性分析和发表偏倚。结果：纳入15项研究，涉及30,022名受试者。年龄0 ~ 75岁（OR = 1.07, 95% CI: 1.04 ~ 1.10）、女性（OR = 1.72, 95% CI: 1.41 ~ 2.10）、糖尿病（OR = 1.76, 95% CI: 1.29 ~ 2.40）、c反应蛋白（CRP）升高（OR = 1.36, 95% CI: 1.14 ~ 1.62）、低教育水平（OR = 1.24, 95% CI: 1.12 ~ 1.38）与AIS后PSCI风险增加显著相关。一些预测因素存在显著的异质性，特别是年龄（I2 = 89.9%）和教育水平（I2 = 89.6%）。结论：高龄、女性、糖尿病、CRP升高、低教育水平等因素与AIS后PSCI风险增加相关。这些发现可能支持风险分层和早期监测策略。然而，在解释汇总估计时，应考虑到某些预测因子观察到的实质性异质性。需要进一步的前瞻性研究来证实这些关联并澄清因果关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuropsychiatric Disease and Treatment CLINICAL NEUROLOGY-PSYCHIATRY

CiteScore

5.10

自引率

3.10%

发文量

328

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed journal of clinical therapeutics and pharmacology focusing on concise rapid reporting of clinical or pre-clinical studies on a range of neuropsychiatric and neurological disorders.