Impact of malnutrition on post-stroke cognitive impairment in convalescent rehabilitation ward inpatients.

Abstract

To investigate the relationship between malnutrition risk on admission and improvement in post-stroke cognitive impairment (PSCI). This retrospective cohort study included 90 patients with PSCI with a Mini-Mental State Examination (MMSE) score ≤ 23, who were admitted to a rehabilitation hospital between July 2013 and December 2015. We assessed the malnutrition risk using the Mini Nutritional Assessment-Short Form (MNA-SF) and cognitive improvement using the Functional Independence Measure cognitive subscale (cognitive FIM) gain. Participants were classified into the malnourished (MNA-SF score ≤ 7) and adequately nourished groups (≥ 8). The patients' age, modified Rankin Scale score, time to hospitalization, and length of stay were recorded. The relationship between nutritional status and cognitive FIM was determined using a multivariate regression model. The study included 47 men and 43 women, with a mean age of 75.0 (standard deviation: 8.7) years. The number of patients in the malnourished and adequately nourished groups were 68 (75.6%) and 22 (24.4%), respectively. The median MMSE score was 19 (interquartile range 15-22), and the median cognitive FIM score at admission was 17 (interquartile range 11-21.8). Univariate analysis showed no significant difference in cognitive FIM gain between the malnourished and adequately nourished groups (P = 0.781). Multivariate regression analysis showed that the MNA-SF score (beta = 0.84, P = 0.009) and cognitive FIM at admission (beta = - 0.347, P < 0.001) were independently related to cognitive FIM gain. Most patients with PSCI were malnourished; malnutrition on admission for rehabilitation was associated with poor improvement after PSCI.