Cognitive performance in Mongolian patients after transient ischemic attack and the impact of vascular risk factors: a case-controlled study

Cognitive impairment is a prevalent occurrence after a transient ischemic attack (TIA), but there is currently insufficient evidence to understand the impact of vascular risk factors (VRFs) on this event. We aimed to determine the occurrence of cognitive impairment following a TIA and to explore whether VRFs correlate with cognitive impairment. This hospital-based case-controlled study recruited patients with TIA aged 45 to 65 years without prior stroke or cognitive decline who underwent the Mini Mental State Examination (MMSE) within 3 months at the Mongolia-Japan Hospital between May and December 2023. Age (±1 year) and sex-matched controls were selected from outpatient departments. One hundred thirty-four patients (N=134) with TIA (61.2% women, mean age, 56.4±6.5 years) were included and compared with 134 controls (61.2% women, mean age, 56.1±6.4 years). Significant differences in MMSE scores were noted between the study groups, with mean scores of 26.32±2.23 for TIA patients and 27.99±1.94 for non-TIA subjects (p<0.0001). In the crude model, the presence of hypertension, a family history of myocardial infarction, hypercholesterinaemia, atrial fibrillation, and having three or more VRFs were all significantly associated with global cognitive performance on the MMSE (all p<0.05). When age, gender and education are controlled for, performance on the MMSE is uniquely accounted for by the presence of atrial fibrillation and having three or more VRFs (all p<0.05). Our results suggest that global cognitive impairment following a TIA may be linked to the number of VRFs in these individuals. This emphasises the importance of sustained management of VRFs beyond the recovery period to mitigate the risk of cognitive impairment.