Baseline cognitive impairment predicts cerebrovascular events in stroke-free chinese adults

Cognitive dysfunction and cerebrovascular diseases are major public health challenges, yet the prognostic role of cognitive impairment before a stroke in populations without stroke history remains unclear. We conducted a community-based longitudinal study on 3,875 Chinese adults aged 40 and older who were free of stroke, assessing their initial cognitive function with the Mini-Mental State Examination (MMSE), where scores less than 24 indicate impairment, and they were followed for 4.1 years. After adjusting for demographic factors, vascular risks, homocysteine, and intracranial arterial stenosis, Cox proportional hazards models indicated that cognitive impairment independently forecasted the occurrence of ischemic stroke [adjusted Hazard Ratio (aHR) = 2.55, 95% Confidence Interval (CI): 1.33–4.87] and any stroke (aHR = 2.32, 95% CI:1.24–4.36), but not all-cause mortality (aHR = 1.79, 95% CI:0.96–3.36).

These findings indicate that baseline cognitive impairment in stroke-free adults aged 40 and older is a significant predictor of future cerebrovascular events, emphasizing its importance in early risk assessment and prevention strategies for groups like Chinese adults who have not experienced a stroke. Asymptomatic Polyvascular Abnormalities Community We thank all the study participants, their relatives, the members of the survey teams of the APAC study. Department of Neurology, Kaifeng Central Hospital, No. 85 Hedao Road, Longting District, Kaifeng, 475000, China Henan Provincial Engineering Technology Research Center for Precision Diagnosis and Treatment of Neuromuscular Diseases, Kaifeng, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China Anxin Wang, Xia Meng, Xue Tian, Jing Li & Xiaoli Zhang Epidemiological Research Office, Beijing Neurosurgical Institute, Beijing, China Anxin Wang, Xue Tian, Jing Li & Xiaoli Zhang Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China The authors declare no competing interests.

The study was approved by the ethics committees of Beijing Tiantan hospital (Approval No: 2010-014-01) and Kailuan General Hospital (Approval No: 2006-05) according to the principles mentioned in the Declaration of Helsinki. All participants or their legal proxies provided written informed consent before enrolment in this study. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Shi, Z., Wang, A., Meng, X. et al. Baseline cognitive impairment predicts cerebrovascular events in stroke-free chinese adults. Sci Rep (2026). https://doi.org/10.1038/s41598-026-78298-4 DOI: https://doi.org/10.1038/s41598-026-78298-4