Prevalence and risk factors of cognitive impairment among stroke survivors in India: an analysis of cross-sectional data from the Longitudinal Ageing Study in India.

OBJECTIVES

This study examines the prevalence of and risk factors associated with cognitive impairment among Indian stroke survivors aged ≥60 using data from the Longitudinal Ageing Study in India (LASI).

DESIGN

Cross-sectional comparative analysis.

SETTING

Secondary analysis of Wave 1 (2017-2019) data from the nationally representative LASI.

PARTICIPANTS

A total of 844 individuals aged ≥60 years with a self-reported history of stroke and 2532 age-matched and gender-matched non-stroke controls selected at a 3:1 ratio from the LASI dataset.

OUTCOME MEASURES: The outcome measure was the prevalence of cognitive impairment among older adults with a history of stroke, assessed using a composite cognitive index (score ≤14) derived from five cognitive domains. We also aimed to identify socio-demographic, socioeconomic, behavioural and health-related factors associated with post-stroke cognitive impairment using multivariable logistic regression models.

RESULTS

Stroke survivors had a higher prevalence of cognitive impairment (15.3%) compared with non-stroke individuals (11.6%) and significantly lower cognitive function (composite score: 22.23 vs 23.78, p<0.001). Stroke significantly increased the risk of cognitive impairment (OR 1.37, 95% CI 1.05 to 1.79, p=0.021), even after adjusting for demographic and health-related factors. Higher expenditure status, higher education and urban residence were strong protective factors, while being single and experiencing depressive symptoms were associated with an increased likelihood of cognitive impairment. Based on a multivariate-adjusted model, risk factors for cognitive impairment among stroke survivors included advanced age (OR 3.54, 95% CI 1.35 to 9.27, p=0.010 (80+ vs 60-64 years)), female gender (2.53, 95% CI 1.32 to 4.86, p=0.005), physical inactivity (1.93, 95% CI 1.03 to 3.61, p=0.039), not in a current relationship (2.08, 95% CI 1.10 - 3.93, p= 0.024) and being underweight (2.97, 95% CI 1.47 to 6.00, p=0.002).

CONCLUSION

Stroke survivors in India face increased risk of cognitive impairment, with associated risk factors including age, female gender, inactivity, depression and low body mass index, while higher education and expenditure status were associated with a reduced risk. Early detection and targeted interventions, including screening, lifestyle changes and personalised rehabilitation, are vital for preserving cognitive health after stroke.