Cognitive impairment frequently occurs following stroke, yet its underlying risk factors remain insufficiently elucidated. This study explored how pre-stroke disability, related factors, and post-stroke cognitive results are connected in elderly Chinese individuals. This study analyzed China Health and Retirement Longitudinal Study (CHARLS) data from 2015 to 2018 to evaluate activities of daily living (ADL) and instrumental activities of daily living (IADL) disabilities using standardized scales. Binary logistic regression analyzed the potential link between pre-stroke ADL disability and subsequent post-stroke cognitive impairment. Subgroup analyses were stratified by age, gender, residence, and education, with sensitivity analyses conducted to test result robustness. Out of 404 participants, 18.1% experienced cognitive decline following a stroke. The logistic regression analysis identified a strong link between functional limitations in ADL or IADL before the stroke and subsequent cognitive impairment ( P < 0.001). Those with impaired ADL function had an elevated risk (OR = 2.20; 95% CI: 1.27–3.75), and a similar pattern was observed for IADL limitations (OR = 3.31; 95% CI: 1.94–5.65). These findings were further supported by sensitivity analyses conducted with linear regression models, reinforcing the reliability of the observed associations. This research verified that limitations in ADL and IADL prior to stroke were significantly linked to cognitive decline following stroke. Among older stroke patients in China, both ADL and IADL impairments emerged as relevant predictors of post-stroke cognitive impairment. Evaluating functional status in adults aged 45 and above may aid in the early detection of those at elevated risk for future cognitive deterioration.
Huang et al. (Sat,) studied this question.