The Relationship between Anxiety and Cognition in Stroke Patients: A Cross-Sectional Study

Background: There is limited evidence on the relationship between anxiety and cognition in stroke patients, and no precise relationship between the two has been indicated. Objective: We aimed to explore the precise relationship between anxiety and cognition in Chinese stroke patients. Methods: This study was a cross-sectional study, 384 hospitalized stroke patients were assessed with questionnaires and scales, including the Demographic Characteristics Questionnaire, the Hamilton Anxiety Inventory (HAMA), and the Montreal Cognitive Assessment (MoCA). Results: Anxiety was present in 55.47% of the 384 patients. Univariate analysis showed that age, gender, marital status, smoking, and alcohol consumption were associated with cognition, and multiple linear regression results showed that HAMA was not independently associated with MoCA after adjusting for potential confounders (β=-0.16, 95% CI: -0.29 to- 0.03), which would be inconsistent with HAMA (subgroup) as a categorical variable (P trend of 0.004) A non-linear relationship was detected between HAMA and MoCA with an inflection point of 9. The effect sizes and confidence intervals to the left and right of the inflection point were -0.54 (-0.78 to -0.30) and 0.02 (-0.14 to -0.17), respectively. Conclusion: The relationship between anxiety and cognition is nonlinear. When the HAMA score is less than 9, anxiety and cognition are negatively correlated, and when it is greater than or equal to 9, the cognitive score will no longer decrease and is saturated.