Excessive Sedentary Time Is Associated with Cognitive Decline in Older Patients with Minor Ischemic Stroke

Article type: Research Article

Authors: Liang, Hongtao^{a; 1} | Yin, Xiang¹ | Chen, Tian^{a; 1} | Zhang, Yan^a | Zhang, Qin^a | Lin, Jie^a | Yin, Huan^a | Tang, Jinghua^a | He, Yingyi^a | Xia, Ping^a | Zhu, Yongping^a | Li, Haihua^a | Mo, Yongbiao^b | Li, Yongyong^c | Wang, Ying^d | Yang, Xiao^{e; *} | Hu, Zicheng^{a; f; *}

Affiliations: [a] Department of Neurology, People’s Hospital of Chongqing Hechuan, Chongqing, China | [b] Department of Emergency, People’s Hospital of Chongqing Hechuan, Chongqing, China | [c] Department of Gerontology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China | [d] Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China | [e] Neuroscience Center, General Hospital of Ningxia Medical University, Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia, Yinchuan, China | [f] Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

Correspondence: [*] Correspondence to: Xiao Yang, Neuroscience Center, General Hospital of Ningxia Medical University, Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia, Yinchuan, China. E-mail: cckk606@sina.com and Zicheng Hu, Department of Neurology, People’s Hospital of Chongqing Hechuan, Chongqing, China. E-mail: drhuzi0329@foxmail.com.

Note: [1] These authors contributed equally to this work.

Abstract: Background:Cognitive impairment is commonly seen after acute ischemic stroke (AIS). Sedentary behaviors increase the risk of dementia among community dwelling population. Objective:This study aims to investigate the association of sedentary behaviors with poststroke cognitive impairment among older adults with minor AIS. Methods:This cohort study recruited 594 older subjects with minor AIS from three hospitals in China during February 1, 2016, and December 31, 2018. Participants were followed up for two years and the sedentary time per day was self-reported at the end of follow-up. Cognitive functions were assessed by Mini-Mental State Examination (MMSE). Participants were categorized into the high and low sedentary time group according to the median sedentary time of the participants. Results:At two years of follow-up, the long sedentary time group had significantly lower MMSE scores than the short sedentary time group [median, (IQR): 21 (18 to 25) versus 22 (18 to 25), p = 0.368]. The long sedentary time group had a higher speed of cognitive decline than the short sedentary time group. Excessive sedentary time was associated with a higher risk of longitudinal cognitive decline (OR: 2.267, 95% CI: 1.594 to 3.225), adjusting for age, sex, education, body mass index, APOE genotype, comorbidities, symptoms of depression, anxiety, and insomnia, baseline MMSE scores and National Institute of Health Stroke Scale scores, cognitive therapy, and TOAST ischemic stroke subtypes. Conclusions:This study identified a possible link between sedentary behaviors and longitudinal cognitive decline among older patients with minor AIS, suggesting that reducing sedentary time might be helpful for preventing poststroke dementia.

Keywords: Acute ischemic stroke, Alzheimer’s disease, cognitive impairment, older adults, sedentary behavior

DOI: 10.3233/JAD-230008

Journal: Journal of Alzheimer's Disease, vol. 96, no. 1, pp. 173-181, 2023