Early cognitive dysfunction after stroke and related risk factors in the high-altitude and multi-ethnic region of Qinghai, China: A multi-center cross-sectional study

Objective: Cognitive impairment is a common outcome of stroke, but there is limited evidence regarding its prevalence at high altitude, especially within the context of specific ethnic groups or lifestyle habits. This pro-spective exploratory study investigated early cognitive impairment after stroke in Qinghai Province, 3000 m above sea level.Methods: Patients with acute stroke (n = 1047) were enrolled from 3 hospitals in Qinghai Province. Cognitive performance was measured by Montreal Cognitive Assessment (MoCA) scores within 5 days of stroke symptom onset; MoCA < 26 defined impairment. Patient data included demographics, education, vascular risk factors, diet, and activities of daily living rated by Barthel index.Results: Cognitive impairment within 5 days of stroke symptom onset affected 77.65% of these patients. The factors independently associated with early cognitive impairment were: older age (mean difference [MD]: -4.857, 95% confidence interval [CI]: 6.685-3.030, P < 0.001); female gender (odds ratio [OR]: 1.674, 95% CI: 1.212-2.313, P = 0.002); and a diet containing yak butter (OR: 1.587, 95% CI: 1.247-2.021, P < 0.001). Pro-gressively lesser odds were accounted to beef (Yak) and mutton consumption (OR: 0.804, 95% CI: 0.655-0.987, P = 0.037); fruit (OR: 0.792, 95% CI: 0.672-0.933, P = 0.005); status as an immigrant (OR: 0.666, 95% CI: 0.445-0.996, P = 0.048); education (OR: 0.514, 95% CI: 0.400-0.660, P < 0.001); and multiple daily leisure activities (OR: 0.999, 95% CI: 0.999-0.999, P < 0.001). Conclusion: Persons in Qinghai province who experience stroke are likely to show signs of early cognitive dysfunction. Preventive modifiable features include diet and daily activities.