Study On The Risk Factors Of Cognitive Dysfunction In Patients With Acute Mild To Moderate Cerebral Infarction

Objective: To study the risk factors of cognitive dysfunction in patients with acute mild to moderate cerebral infarction,and to provide scientific basis for early intervention and treatment of patients with cognitive impairment.Methods: The case data of 260 patients with acute mild to moderate cerebral infarction admitted to Pingxiang People’s Hospital from July 2016 to December 2019 were collected.Cognitive function of these patients was assessed using the Montreal Cognitive Assessment Scale(MoCA)90 days after the onset of the disease,and the patients were divided into a cognitive impairment group(MoCA<26 points)and a normal cognitive function group(MoCA ≥ 26 points).Finally,univariate and multivariate analysis were used to explore the risk factors related to cognitive dysfunction in patients,and Nomogram was drawn using R4.0.3 software to establish a predictive model for cognitive dysfunction in patients with acute mild to moderate cerebral infarction.This model is validated.Results:1.There were 178 patients with cognitive dysfunction,and the incidence rate was 68.46%.The results of univariate analysis showed that compared with the normal group,the cognitive impairment in patients with acute mild to moderate cerebral infarction had no statistical differences in gender,education level,smoking,drinking,and hyperlipidemia,while age,hypertension,diabetes mellitus were not statistically different.,hyperuricemia,carotid atherosclerosis,hyperhomocysteinemia,degree of cerebral infarction and cognitive impairment were significantly different(P<0.05).2.The multivariate Logistic regression results showed that after including the variables with statistical significance(P<0.05)in single factor,the analysis found that age,hypertension,diabetes,hyperuricemia,carotid atherosclerosis,high isotype Cystinemia and degree of cerebral infarction are related risk factors for cognitive dysfunction in patients with acute mild to moderate cerebral infarction,among which diabetes is the most risk factor for cognitive dysfunction in patients with acute mild to moderate cerebral infarction(OR=8.326,95%CI=3.665-18.915,P<0.001),followed by hypertension(OR=6.502,95%CI=2.967-14.252,P<0.001).3.On the basis of the multi-factor Logistic regression results,the Nomogram prediction model was constructed,and the Bootstrap self-sampling method was used to verify it internally.The C-statistic was 0.871(95%CI=0.8269-0.9151),and the area under the ROC curve was AUC=0.871,which proves that the model has a good degree of discrimination,and the calibration curve of the model is close to the standard line,which proves that the model has a good degree of calibration.Conclusion:1.The incidence of cognitive impairment in patients with acute mild-to-moderate cerebral infarction is high,which needs urgent attention.2.Age,hypertension,diabetes,hyperuricemia,carotid atherosclerosis,hyperhomocysteinemia,and degree of cerebral infarction are independent risk factors for cognitive dysfunction in patients with acute mild to moderate cerebral infarction.3.In this study,a simple and intuitive Nomogram prediction model was constructed,which has good discrimination and calibration,and can intuitively and accurately assess the risk of cognitive impairment in patients with acute mild to moderate cerebral infarction.However,a large-scale longitudinal study is still needed to further explore its clinical applicability.