Metabolic syndrome is associated with cognitive impairment after transient ischemic attack/mild stroke, but does not affect cognitive recovery in short term.

The metabolic syndrome (MetS) is a cluster of risk factors for cognitive impairment. We aimed to investigate the association between MetS and risk of persistent cognitive impairment in patients with a transient ischemic attack (TIA) or mild ischemic stroke. This is a prospective and observational study in consecutive patients with first-ever TIA or mild stroke (National Institutes of Health Stroke Scale score ≤ 6). Patients underwent Montreal cognitive assessment (MoCA) at hospital admission and day 30 after discharge. We defined cognitive impairment as a MoCA score of ≤26. Persistent cognitive impairment was defined as baseline cognitive impairment and an increase of <2 point or decrease in MoCA score at 1 month after discharge. Three hundred eleven eligible patients were enrolled, aged 21-80 years, and mean age was 61.87 ± 9.643 years and 211 patients were males (70.1%). Cognitive impairments were present in 166 (53.4%) patients at admission. The cognitive impairment rate was significantly higher in MetS patients than those without MetS both at admission and day 30 after discharge (66.1% vs 33.6%, P < 0.001 and 56.6% vs 27.9%, P < 0.001). In logistic regression analysis, MetS, hyperglycemia, hypertension, dyslipidemia, and obesity had no significant interaction with persistent cognitive impairment. However, hypertension had a tendency to be a predictor of persistent cognitive impairment, although this tendency had no statistical significance (odds ratio = 2.545, 95% confidence interval 0.872, 7.430, P = 0.0874). Baseline MetS is associated with the risk of cognitive impairment, but MetS does not affect short-term cognitive recovery from cognitively impaired in patients with TIA/mild stroke.