Abstract 276: Evaluating the Frequency of Prestroke Cognitive Impairment Among Stroke Patients: Neurological and Functional Correlates

Introduction Prestroke cognitive impairment is a critical factor that can significantly impact stroke recovery, yet it is often underrecognized. This study aims to quantify the frequency of prestroke cognitive impairment among stroke patients and to explore its neurological and functional correlates. Methods We conducted a comprehensive assessment of 520 stroke patients, employing the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) to diagnose cognitive impairment prior to stroke. Neurological evaluations included the assessment of neuropsychiatric symptoms using the Neuropsychiatric Inventory Questionnaire (NPI‐Q), while functional abilities were measured through Activities of Daily Living (ADL) scales. Additionally, neuroimaging analyses were performed to identify structural brain abnormalities. Results Our study found that 32.5% of stroke patients exhibited cognitive impairment prior to their stroke. This impairment was strongly associated with more severe neuropsychiatric symptoms, as evidenced by higher NPI‐Q scores (5.5 ± 4.9 vs. 1.7 ± 2.3, p < 0.001), and greater functional limitations, reflected in ADL scores (1.8 ± 1.9 vs. 0.3 ± 0.8, p < 0.001). Regression analyses further identified older age, the presence of white matter lesions, and medial temporal lobe abnormalities as significant neurological correlates of cognitive impairment. Conclusion The study highlights a substantial prevalence of prestroke cognitive impairment in stroke patients and its strong association with both neuropsychiatric symptoms and functional limitations. These findings underscore the importance of early and proactive cognitive assessments in stroke populations. By identifying cognitive impairment before a stroke, healthcare providers can tailor rehabilitation strategies more effectively, potentially leading to improved outcomes for stroke survivors. Integrating routine cognitive evaluations into stroke care protocols may enhance patient recovery and overall quality of life.