ABSTRACT NUMBER: ESOC2026A654 INCIDENCE AND CORRELATES OF POST ISCHEMIC STROKE COGNITIVE IMPAIRMENT AND UTILITY OF MOCA IN PREDICTING FUNCTIONAL DEPENDENCE AT 3 MONTHS: A PROSPECTIVE COHORT STUDY

Abstract Background and aims Stroke remains a leading cause of disability worldwide, and post-ischemic stroke cognitive impairment (PISCI) is a frequent complication that negatively affects recovery, caregiver burden, and survival. Early identification of cognitive impairment is crucial for improving outcomes. Methods This prospective study included 124 patients with ischemic stroke who were followed for 3 months. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) at baseline and at 3 months, with scores <25 indicating cognitive impairment. Functional outcomes were evaluated using the Modified Rankin Scale (mRS). Receiver operating characteristic (ROC) curve was used to identify the MoCA cutoff for predicting functional dependence. Results The mean age of participants was 55.16 years. At 3 months, 49% of patients had PISCI. Mean MoCA scores improved from 18.6 (baseline) to 23.4 at follow-up. Visuospatial and executive domains were most affected, while naming and orientation were least impaired. Attention and delayed recall showed the greatest improvement. No significant association was found between vascular risk factors and PISCI at 3 months. Patients who received early interventions, such as thrombolysis, demonstrated better cognitive recovery. Functionally, 67.7% achieved good outcomes (mRS 0–2). Large artery atherosclerotic and cardiogenic strokes were associated with poorer outcomes compared to lacunar strokes. A baseline MoCA score <15 predicted functional dependence at 3 months with 95% sensitivity and 95.2% specificity. Conclusions PISCI is highly prevalent in Indian stroke survivors. Baseline MoCA is a valuable tool for early prediction of poor functional outcomes. Identifying patients with MoCA ≤15 allows targeted interventions to improve recovery and independence after stroke. Conflict of interest Dr Purushottam Singh: Nothing to disclose, Dr Pawan Dhull: Nothing to disclose, Dr subrat kumar nanda: Nothing to disclose, Dr Anirban Gupta: Nothing to disclose