The Relationship between Glycosylated Hemoglobin and Cognitive Dysfunction after Acute Ischemic Stroke

Abstract

Background: Stroke takes the second place among worldwide causes of morbidity and mortality. Significant attention was paid to the relationship between Glycosylated hemoglobin (HbA1c) and cognitive functions in patients with acute ischemic stroke (AIS). This study aims at assessing the relationship between post stroke cognitive impairment (PSCI) and HbA1c levels as well as other factors that may predict cognitive decline in those patients. Patients and Methods: 110 patients with a diagnosis of AIS were included in this study. Cognitive functions were evaluated after 3 months of the onset using the Montreal Cognitive Assessment scale (MoCA). Demographic, clinical features, laboratory parameters including HbA1C level as well as imaging findings were analyzed and relationship with PSCI were determined.Results: PSCI was significantly related to Type 2 diabetes mellitus (P < 0.001) and to Sphincter dysfunction (P 0.04). Elevated HbA1c level and lower levels of high density lipoprotein (HDL) were significant in the group of PSCI (P value <0.001 and 0.021 respectively), as well as increased carotid intima media thickness (CIMT) on Carotid Doppler examination (P value 0.013). The increase of CIMT and higher levels of HbA1c were independent risk factors for cognitive dysfunction in acute ischemic stroke patients, with odds ratio of 0.002 (0, 0.145), 2.088 (1.601, 2.723) respectively, (95% confidence interval).Conclusion: The occurrence of PSCI was independently related to higher Glycosylated hemoglobin levels and increased CIMT. Careful evaluation of these factors help clinician to intervene early and develop better treatment modalities.