Association between pre-stroke frailty status and post-stroke cognitive impairment in patients with acute large artery atherosclerotic cerebral infarction

The aim of this study was to investigate the correlation between pre-stroke frailty status and post-stroke cognitive impairment (PSCI) in patients with acute large artery atherosclerotic cerebral infarction. One hundred and eight patients with acute large artery atherosclerotic cerebral infarction admitted in our hospital from July 2020 to July 2023 were prospectively enrolled. Patients were stratified into frailty (46 cases) and non-frailty groups (62 cases) based on FRAIL scale scores. During the 6-month follow-up after the onset of cerebral infarction, patients were evaluated using the Chinese modified version of Montreal Cognitive Assessment (MoCA) scale for cognitive function and were divided into PSCI (52 cases) and non-PSCI (56 cases) groups. The frailty group showed significantly higher age, prevalence of hypertension and diabetes comorbidities, smoking and alcohol consumption rates, National Institutes of Health Stroke Scale (NHISS) score, and Modified Rankin Scale (mRS) score than those in the non-frailty group (P<0.05, P<0.01). The incidence of PSCI in the frailty group was also significantly higher than that in the non-frailty group (78.3 vs 25.8%, P<0.01). Compared to the non-PSCI group, the PSCI group had higher age, shorter education duration, fewer cases of reperfusion therapy, and greater frailty (P<0.05, P<0.01). Logistic regression analysis showed that pre-stroke frailty was an independent risk factor for PSCI (P<0.01). Timely assessment of the frailty status in patients with acute large artery atherosclerotic cerebral infarction is beneficial for preventing, delaying onset, and reducing the incidence of PSCI.