Prevalence and factors influencing cognitive impairment among older adult stroke survivors in Taiwan: A national cross-sectional study

BACKGROUND: Stroke survivors may experience cognitive impairment, which can seriously affect their lives and increase the burdens of main caregivers. Factors affecting cognitive impairment in stroke survivors are less well investigated nationally. AIMS: This study estimated the prevalence of and applied a biopsychosocial framework to explore physiological, psychological, and social factors influencing cognitive impairment among older adult stroke survivors in Taiwan. METHODS: This was a secondary data analysis study using a database from the Taiwan Longitudinal Study on Aging, a population-based survey. Potential risk factors of cognitive impairment in stroke survivors included demographic characteristics, chronic diseases, oral health problems, basic activities of daily living (ADLs), instrumental ADLs (IADLs), weekly exercise behavior, depression, and emotional support. Logistic multiple regression analysis was used to analyze the data. RESULTS: Among 495 stroke survivors, 222 participants were experiencing cognitive impairment, for a prevalence rate of 44.9%. The results showed that the higher the oral health problems score (odds ratio [OR]: 1.09, p = .003) and the IADL score (OR: 1.19, p < .001) were associated with increased risk of cognitive impairment. By contrast, a higher emotional support score was associated with a lower cognitive impairment risk (OR: 0.74, p = .008). CONCLUSION: Stroke patients are predisposed to cognitive impairment. This study highlights the importance of maintaining oral health, promoting IADLs, and providing emotional support to prevent cognitive impairment in stroke survivors.