Relationship between white matter hyperintensity and cognitive impairment in elderly patients with initial transient cerebral ischemia/mild stroke

Abstract

Objective To investigate the correlation between cognitive impairment and white matter hyperintensity (WMH) in elderly patients with initial transient cerebral ischemia/mild stroke. Methods From January 2015 to December 2018, a total of 105 elderly patients with initial transient cerebral ischemia/mild stroke who met the criteria at the Department of Neurology, Xishan People's Hospital of Wuxi were enrolled in this study. All patients underwent cranial MRI and other examinations. The patients was divided into a non-cognitive impairment group, temporary cognitive impairment group, and persistent cognitive impairment group according to MoCA scale score. The differences in age, NIHSS score, and MOCA score among the three groups were compared by one-way ANOVA, and the differences between the two groups were compared by Q-test. The differences in sex (male), hypertension, diabetes, hyperlipidemia, MRI image changes, and infarct location were compared by the Chi-square test. Multivariate Logistic regression was used to analyze the risk factors for cognitive dysfunction in elderly patients with initial transient cerebral ischemia/mild stroke. Results Age and the proportions of males and those with white matter hyperintensity were significantly higher in the persistent cognitive impairment group than in the non-cognitive impairment (P 0.05). Patients with more severe WMH lesions were significantly more likely to develop cognitive impairment (P<0.05). After adjusting for age, sex, hypertension, diabetes, and other factors, age (OR=1.08, 95%CI: 1.01-1.15, P=0.021) and moderate-to-severe WMH lesions (OR=1.66, 95%CI: 0.79-2.89, P=0.042) were significantly associated with the development of persistent cognitive dysfunction after initial transient cerebral ischemia/mild stroke in the elderly patients (P<0.05). Conclusion Age and moderate-to-severe WMH lesions are risk factors for persistent cognitive impairment in elderly patients with initial transient cerebral ischemia/mild stroke. Key words: Transient ischemic attack; Mild stroke; White matter hyperintensity; Cognitive impairment