Diabetes Mellitus Predicts Cognitive Impairment in Patients With Ischemic Stroke

Background: Non-insulin-dependent diabetes mellitus (NIDDM) is associated with an increased incidence of cognitive impairment. Methods: A retrospective chart review study involving 707 patients admitted for rehabilitation after an ischemic stroke. Cognitive status was assessed by the Mini-Mental State Examination (MMSE), and scores lower than 24 points were considered suggestive of cognitive impairment. Results: Age, gender, NIDDM, dementia, and previous stroke emerged as the only statistically significant parameters differing between those with MMSE score lower than 24 or higher. After adjusting for confounding variables, NIDDM (odds ratio 1.46, 95% CI 1.05-2.05, P = .02) was associated with an increased risk of cognitive impairment. Conclusions: Our findings suggest that NIDDM is independently associated with lower MMSE scores in ischemic stroke patients. It identifies individuals in need of specifically targeted interventions and may assist in selecting and developing resources for cognitively impaired diabetic patients.