Predictors of Cognitive Functions After Stroke Assessed Using the Wechsler Adult Intelligence Scale: A Retrospective Study

Article type: Research Article

Authors: Su, Wenlong^{a; b} | Li, Hui^{d; b; c} | Dang, Hui^{d; b; c} | Han, Kaiyue^{a; c} | Liu, Jiajie^{a; c} | Liu, Tianhao^{a; c} | Liu, Ying^{a; c} | Tang, Zhiqing^{a; c} | Lu, Haitao^{a; c} | Zhang, Hao^{a; b; c; d; *}

Affiliations: [a] China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, China | [b] School of Health and Life Science, University of Health and Rehabilitation Sciences, Qingdao, China | [c] China Rehabilitation Research Center, Beijing Bo’ai Hospital, Beijing, China | [d] Cheeloo College of Medicine, Shandong University, Jinan, China

Correspondence: [*] Correspondence to: Hao Zhang, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Jiaomen North Rd 10, Fengtai District, Beijing 100068, China. E-mail: crrczh2020@163.com.

Abstract: Background:The mechanism(s) of cognitive impairment remains complex, making it difficult to confirm the factors influencing poststroke cognitive impairment (PSCI). Objective:This study quantitatively investigated the degree of influence and interactions of clinical indicators of PSCI. Methods:Information from 270 patients with PSCI and their Wechsler Adult Intelligence Scale (WAIS-RC) scores, totaling 18 indicators, were retrospectively collected. Correlations between the indicators and WAIS scores were calculated. Multiple linear regression model(MLR), genetic algorithm modified Back-Propagation neural network(GA-BP), logistic regression model (LR), XGBoost model (XGB), and structural equation model were used to analyze the degree of influence of factors on the WAIS and their mediating effects. Results:Seven indicators were significantly correlated with the WAIS scores: education, lesion side, aphasia, frontal lobe, temporal lobe, diffuse lesions, and disease course. The MLR showed significant effect of education, lesion side, aphasia, diffuse lesions, and frontal lobe on the WAIS. The GA-BP included five factors: education, aphasia, frontal lobe, temporal lobe, and diffuse lesions. LR predicted that the lesion side contributed more to mild cognitive impairment, while education, lesion side, aphasia, and course of the disease contributed more to severe cognitive impairment. XGB showed that education, side of the lesion, aphasia, and diffuse lesions contributed the most to PSCI. Aphasia plays a significant mediating role in patients with severe PSCI. Conclusions:Education, lesion side, aphasia, frontal lobe, and diffuse lesions significantly affected PSCI. Aphasia is a mediating variable between clinical information and the WAIS in patients with severe PSCI.

Keywords: Alzheimer’s disease, cognitive impairment, predictor, stroke, WAIS-R

DOI: 10.3233/JAD-230840

Journal: Journal of Alzheimer's Disease, vol. 98, no. 1, pp. 109-117, 2024