Investigation Of The Relationship Between Mild Cognitive Impairment And Serum Sexual Hormones Level After Acute Ischemic Stroke Of Old Women

Background and Objective:Mild cognitive impairment, MCI, is one of the common clinical situations occurs after ischemic stroke. The degree of the functional cognitive damage lies between normally aging and dementia. The level of serum sexual hormones has important effect on cognitive function of adults, and it changes markedly especially after ischemic stroke. Several clinical and animal studies have identified that there is apparent correlation between cognitive impairment and the level of serum sexual hormones after chronic cerebral ischemia. The present study illuminates initially the relationship between the cognitive impairment and the level of serum sexual hormones in aged females through comparing the sexual hormones level of MCI group with that of control group after acute ischemic stroke, and through processing regression analysis with other possible factors. So that the study may provide evidence to the elucidation of patho-physiological mechanism of the cognitive impairment after ischemic stroke and to the investigation of new therapeutics to improve cognitive function.Methods:1.The study objects of aged females were collected according to the cases entry criterion.2. The general information (age, education level) and previous disease history of the cases, the records of the infarction location and size etc. were collected. The fast venous serum concentration of sexual hormones were detected on the next morning in admission. NIHSS and MoCA were used to evaluate the neurological deficits and cognition impairment.3. The objects were divided into 2 groups(cognition impaired group and normal group) according to MoCA scores. 4. The general information, previous disease history, characteristics of the infarction and neurological deficits and the level of sexual hormones were compared between the cognition impaired and normal groups.5. The risk factors that might contribute to the cognitive impairment were analysed by logistic regression.Results:1. Prevalence of cognitive impairment. There were 72 cases in our study and 48 cases arose cognitive impairment, with a percentage of 58.33%.2. Sexual hormone levels. Compared with cognition normal group, the cognition impaired group had lower serum concentrations of P2 and E2, P<0.001.3. Cognition and other factors. The cognition impaired group had significant higher ages, lower educations, higher percentage of ischemic stroke histories and higher NIHSS scores.4. Logistic regression. Previous history of cerebral infarction, lower levels of P4 and E2 are important risk factors for the incidence of post cerebral infarction cognitive impairment.5. P4 and E2 level of the MCI group showed descending tendency according to the aggravation of the cognitive impairment.6:LH and FSH level of MCI group increased compared with normal group,but there is no significant difference.7:In MCI group, P4 and E2 level showed negative correlation with the visual space, executive capacity, attention and delay memory.Conclusions:1.There was a high incidence of cognitive impairment after acute cerebral infarction.2. Aged females with cognitive impairment after cerebral infarction often had higher ages and lower education level.3. Serum level of P4 and E2 decreased in MCI cases.4. Serum level of LH and FSH increased insignificantly in MCI cases, which suggested that primary hypogonadism might occur in MCI females after acute ischemic stroke. But the accompany of central regulation disorder couldn't be excluded. 5.The effect of P2 and E2 on cognitive function varied according to the damage of cognition. They has protective impact on word memory, visual space, delay recall and executive capacity.