Diabetes Mellitus and Post Stroke Cognitive Recovery After Ischaemic Stroke: A Study from Tertiary Care Centre in South India

Background

Stroke is a leading cause of disability and mortality and is frequently associated with cognitive impairment. Diabetes mellitus is a common comorbidity in ischaemic stroke and is linked with poor neurological outcomes. However, longitudinal evidence comparing the burden of post-stroke cognitive impairment and cognitive recovery trajectories between patients with and without diabetes remains limited.

Purpose

The present study compared the prevalence and severity of cognitive impairment in ischaemic stroke patients with and without diabetes mellitus at baseline and on day 90 post-stroke, and evaluated whether diabetes mellitus influences the trajectory of cognitive recovery over 90 days.

Methods

In this longitudinal follow-up study, 401 ischaemic stroke patients (167 with diabetes mellitus and 234 without) underwent cognitive assessment using the Montreal Cognitive Assessment (MoCA) scale at baseline and at 90 days post-stroke. Between group comparisons (diabetes vs non-diabetes) were performed using appropriate parametric or non-parametric tests. Cognitive recovery trajectories were analysed using a linear mixed-effects model.

Results

Patients with diabetes mellitus were significantly older ( p = .011) and had a higher prevalence of hypertension ( p < .001) and atrial fibrillation ( p = .035) than those without diabetes.

In the linear mixed-effects model, MoCA scores improved significantly from baseline to day 90 ( β = 6.13, SE = 0.36, p < .001), indicating overall cognitive recovery. Diabetes mellitus was associated with lower MoCA scores ( β = −1.36, SE = 0.74, p = .065), but the interaction between time and diabetes was not significant ( p = .931), suggesting comparable cognitive recovery over time in both groups. Cognitive outcomes demonstrated significant improvement from baseline to 90 days post-stroke in both groups.

Conclusion

Patients with diabetes demonstrated a greater burden of cognitive impairment at baseline and on day 90; however, cognitive improvement over 90 days was comparable regardless of diabetes status.