Objective To investigate the major correlation factors of vascular cognitive impairment (VCI) and
its subtypes including VCI-no dementia (VCIND) and vascular dementia (VaD).
Methods A total of 491 patients with acute ischemic stroke admitted in Neurology Department
of Tianjin Medical University General Hospital during June 2014 to June 2015 were recruited in
this study. General demographic information, medical history, physical examination, vascular risk
factors, laboratory and image data recorded in our previously established VCI database were used
to assess. The National Institutes of Health Stroke Scale (NIHSS) scores, mechanism of ischemic
stroke (the Trial of Org 10 172 in Acute Stroke Treatment, TOAST), Essen scores, Montreal
Cognitive Assessment (MoCA), Clinical Dementia Rating (CDR), and Activities of Daily Living
(ADL) after (10±2) days of stroke. Recruited patients were divided into VCI group and no cognitive
impairment (NCI) group according to the Guide for Diagnosis and Treatment of VCI. Patients with
VCI comprised of those with VCIND and VaD. Inter-group differences and correlations of factors
mentioned above were analyzed.
Results Among 491 cases of patients with acute ischemic stroke, VCI accounted for 69.86% which
was composed of 37.68% of VCIND and 32.18% of VaD. (1) Comparing to NCI group, patients
with VCI were more likely to have higher low-educational status (P <0.001), diabetes (P =0.005),
heart disease (P =0.045), family history of stroke (P =0.005), supratentorial stroke (P <0.001), stroke
frequency (P =0.014), higher Essen scores (P =0.024), stroke severity (NIHSS) scores (P <0.001) and
D-Dimer level (P =0.001), lower proportion of female (P =0.004) and subtentorial stroke (P <0.001),
and less education year (P <0.001), which had significant differences. Logistic regression analysis
showed that lower educational status, diabetes, supratentorial stroke, higher D-Dimer level were
independent risk factors for VCI. (2) In VaD group, the proportion of prior stroke (P =0.013), TOAST
subtype large artery atherosclerotic cerebral infarction (P <0.001) and stroke frequency (P =0.001),
Essen scores (P =0.032), stroke severity (NIHSS) scores (P =0.005) were significantly higher than those
in VCIND group. Frequency of small-vessel occlusion (lacune) and infratentorial stroke (P <0.001)
and proportation of subtentorial stroke (P <0.001) in VCIND were lower than VaD group, which had
significant differences. Logistic regression analysis showed that stroke frequency, stroke severity
(NIHSS) scores and large artery atherosclerotic cerebral infarction were independent risk factors for
VaD. The risk of VaD in patients with infratentorial stroke was obviously lower than supratentorial
stroke patients.
Conclusion Compared to NCI group, the influential factors for VCI and its subtypes differ. Low
educational status, diabetes, supratentorial stroke, higher D-Dimer level were independent risk
factors for VCI. Compared to VCIND group, stroke frequency, stroke severity (NIHSS) scores and
large artery atherosclerotic cerebral infarction were found to be the risk factors of VaD.
