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Yan, Wenci, Quinn, Terence, McConnachie, Alex, Broomfield, Niall 
ORCID: https://orcid.org/0000-0003-2599-3435, Wong, Yun, Dickie, David, Forbes, Kirsten, Walters, Matthew and Dawson, Jesse
(2026)
Change in cognition following ischaemic stroke.
Annals of Clinical and Translational Neurology, 13 (1).
pp. 14-20.
ISSN 2328-9503
Abstract
Objective: Cognitive decline can occur following ischaemic stroke. How cognition changes over time and associations with cognitive change are poorly understood. This study aimed to explore these issues over 2 years following ischaemic stroke. Methods: This analysis used data from the XILO-FIST study, a clinical trial of allopurinol versus placebo in people with ischaemic stroke according to Tissue-Based Definition. Participants underwent clinical assessment, brain MRI at baseline, and Montreal Cognitive Assessment (MoCA) at baseline, year 1 and year 2. We defined cognitive impairment as a MoCA score < 26 and cognitive change as a difference in MoCA score of 2 points or more at year 1 or year 2 after randomisation. Associations with cognitive impairment and cognitive change were assessed by univariable analysis and multiple logistic regression. Results: Three hundred and sixty participants with complete MoCA data were included. Mean age was 65.4 (SD 8.36) years, and mean baseline MoCA score was 26.4 (SD 2.7). Seventy-seven participants had second-year cognitive improvement. Eighty-four had second-year cognitive decline. After adjustment for age and education year, second-year cognitive improvement was associated with smaller brain volume, lower albumin level, smoking and greater white-matter hyperintensity, and second-year cognitive decline was associated with peripheral arterial disease, higher cholesterol level, small-vessel stroke and greater white-matter hyperintensity. Interpretation: Cognition is dynamic following stroke, with different patterns of change. Brain reserve and vascular risk factors relate to later post-stroke cognitive change. This complex nature of cognitive trajectory has implications for cognitive rehabilitation provision and cognitive impairment detection after stroke.
| Item Type: | Article |
|---|---|
| Additional Information: | Data Availability Statement: Study data will be shared with academic investigators or health care professionals following review and approval of a proposal and subject to a data sharing agreement (contact: jesse.dawson@glasgow.ac.uk). This work was supported by the UK Stroke Association and British Heart Foundation [grant number TSA BHF 2013/01]. The work of Dr. David Dickie and Prof. Terence Quinn was funded by the Stroke Association. |
| Uncontrolled Keywords: | cognitive impairment,cognitive trajectory,post-stroke cognition,risk factor,stroke,clinical neurology,general neuroscience ,/dk/atira/pure/subjectarea/asjc/2700/2728 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health) |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 22 Sep 2025 11:30 |
| Last Modified: | 18 Jun 2026 20:43 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/100444 |
| DOI: | 10.1002/acn3.70192 |
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