Association between medium-chain triglyceride intake and Functional Independence Measure-cognition score in adults following stroke: A retrospective cohort study.

BACKGROUND

Limited evidence exists regarding the cognitive and physical improvement effects of medium-chain triglyceride (MCT) intake in patients with stroke. This study aimed to investigate the association between MCT-enhanced rice consumption and enhancements in outcomes, including cognitive level, in patients following stroke.

METHODS

We performed a retrospective cohort study on adults admitted to a rehabilitation center with cognitive decline following acute stroke. Our exposure of interest was 1 cup of MCT-enhanced rice 3 times per day. Our comparator was 1 cup of regular rice 3 times per day. Our primary outcome was the cognitive level, defined as the Functional Independence Measure-cognition (FIM-cognition) score (continuous variable) at discharge. Our secondary outcomes were changes in FIM-cognition from admission to discharge, defined as FIM-cognition gain, activities of daily living (determined by the FIM-motor score), and swallowing function (determined by the Food Intake Level Scale [FILS] at discharge). Propensity score matching and multivariable regression analyses were used to evaluate the association between MCT provision and the outcomes.

RESULTS

After applying the exclusion criteria, 659 patients with baseline cognitive impairment (mean age 76.1 years; 52.8% men) were analyzed. Following propensity score matching, patients who received MCT-enhanced rice showed significantly greater FIM-cognition gain (median [95% CI]: 9 [5,15] vs 8 [5,12]; P = 0.002) compared with those who did not. Additionally, the MCT-enhanced rice group exhibited significantly higher FIM-motor scores (59 [41,79] vs 56 [31,77]; P = 0.019) and FILS scores (10 [9,10] vs 9 [8,10]; P = 0.027) at discharge than those without. Multivariable linear regression analysis using the analytical cohort confirmed the independent association between MCT intake and improved discharge scores of FIM-cognition, FIM-motor, and FILS.

CONCLUSIONS

The provision of MCT-enhanced rice was associated with improved cognitive level, activities of daily living, and swallowing function in poststroke patients with cognitive impairment.