Deans' stroke musings: BMI may affect cognitive impairment after stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, July 21, 2021

BMI may affect cognitive impairment after stroke

My BMI pre-stroke was 125. My doctor did nothing to get me back to my previous physical fitness level(cardiovascularly an athlete) so I gained 30 lbs. It didn't affect my cognitive abilities at all.

BMI may affect cognitive impairment after stroke

Patients with higher or lower BMIs faced significantly greater risks for global cognitive function and frontal domain performances following an ischemic stroke, according to a study published in Scientific Reports.

“BMI might differentially affect cognitive domains after ischemic stroke,” Minwoo Lee, of the department of neurology at Hallym Neurological Institute in South Korea, and colleagues wrote. “Although being underweight may negatively affect global cognition post-stroke, obesity could induce frontal lobe dysfunctions, specifically phonemic and semantic word fluency.”

Image of brain with ischemic stroke — *Source: Adobe Stock*

Lee and colleagues evaluated 335 patients who survived an ischemic stroke. After patients completed the Korean-Mini Mental Status Examination and the vascular cognitive impairment harmonization standards neuropsychological protocol at 3 months following their stroke, the researchers analyzed patients’ frontal lobe functions using semantic and phonemic fluency, processing speed and mental set shifting. Investigators stratified patients into four groups based on BMI, with quartile 1 (Q1) having the lowest BMIs (< 21.87 kg/m²) and Q4 having the highest (> 25.97 kg/m²).

The average age of patients was 64.8 years, and 38.9% were women. The mean BMI was 23.89 kg/m², with a range of 15.82 kg/m² to 32.93 kg/m². Patients’ stroke severity did not differ significantly. Lee and colleagues found that hypertension was more common among patients in the Q4 group compared with those with lower BMIs. Also, patients in the Q1 group showed significantly lower global cognitive functions than those in the Q2 and Q4 BMI groups. The Q4 group demonstrated significantly lower phonemic and semantic word fluencies than those in Q2, although their levels of global cognitive function were similar. Overall, Lee and colleagues’ analysis revealed that a lower BMI correlated with a higher risk for global cognitive impairment, and a higher BMI correlated with significantly worse frontal dysfunction.

“To our knowledge, this study is the first to evaluate BMI and domain-specific cognitive outcomes using a comprehensive, standardized, neuropsychological protocol in relation to a multicenter cohort of stroke patients,” Lee and colleagues wrote. They added, “Taken together, lower BMI and higher BMI may have differential pathophysiological roles in cognitive impairment after stroke.”