Relationship between Post-Stroke Cognitive Impairment and Severe Dysphagia: A Retrospective Cohort Study

Abstract

Objective: To investigate the relationship between post-stroke cognitive impairment (PSCI) and severe post-stroke dysphagia (PSD) and explore the risk factors related to PSCI combined with severe PSD. Methods: Data from patients were collated from the rehabilitation-specific disease database. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Videofluoroscopy Swallowing Study (VFSS), Penetration-aspiration Scale (PAS), and Functional Oral Intake Scale (FOIS) were used to evaluate cognitive and swallowing functions. Differences between groups were determined by the Pearson chi-square test (χ2) or Fisher exact test. PAS and FOIS data were analyzed with the use of the Wilcoxon rank-sum or Kruskal–Wallis test in the prespecified subgroup analysis. Risk factors were investigated by multivariate logistic regression. Results: A total of 1555 patients were identified with PSCI. The results indicated that patients with PSCI had a higher incidence rate of severe PSD as compared to patients without PSCI (p p = 0.024), while mild PSCI patients mainly manifested pharyngeal phase dysfunction (p p 0.001). In addition, multivariate logistic regression revealed pneumonia (p p p = 0.006) were related to PSCI, combined with severe PSD. Conclusion: PSCI may be related to severe PSD. Patients with severe PSCI were more likely to manifest oral phase dysfunction, while mild PSCI manifested pharyngeal phase dysfunction. Pneumonia, tracheotomy, and dysarthria were risk factors related to PSCI combined with severe PSD.

Keywords

• post-stroke cognitive impairment (PSCI)
• severe post-stroke dysphagia (PSD)
• Videofluoroscopy Swallowing Study (VFSS)
• Penetration-aspiration Scale (PAS)
• Functional Oral Intake Scale (FOIS)
• retrospective study