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A nomogram for predicting post-stroke cognitive impairment no dementia in patients with first-ever mild ischemic stroke
Zhenjie Teng, Jing Feng, Xiaohua Xie, Tianyuan Guan, Jing Xu, Xin Jiang, Yan-Zhong Chang, Peiyuan Lv. Frontiers in Neurology, 2025-08-19
Topic: Risk, prevention and care in population studies
Objective To identify significant predictors and construct a validated nomogram for predicting post-stroke cognitive impairment no dementia (PSCIND) risk among first-ever mild ischemic stroke (MIS) patients. Methods This retrospective cohort study analyzed 242 first-ever MIS patients categorized into normal cognitive (n = 137) and PSCIND (n = 105) groups. Comprehensive data encompassing demographic characteristics, laboratory parameters, cerebral small vessel disease (CSVD) imaging markers, neuropsychological assessments, and ischemic stroke lesion characteristics were collected. Predictor selection was conducted through least absolute shrinkage and selection operator (LASSO) regression analysis, followed by multivariable logistic regression for nomogram construction. Model performance was assessed through discrimination (area under the curve), calibration (calibration plots, Hosmer-Lemeshow test), and clinical utility (decision curve analysis). Results Eight independent predictors were identified: age (OR = 1.060, 95% CI: 1.016–1.106), education level (OR = 0.917, 95% CI: 0.845–0.995), type 2 diabetes mellitus (OR = 9.407, 95% CI: 3.761–23.528), superoxide dismutase (OR = 0.951, 95% CI: 0.931–0.972), uric acid (OR = 1.006, 95% CI: 1.002–1.010), homocysteine (OR = 1.058, 95% CI: 1.027–1.091), strategic infarcts (OR = 4.566, 95% CI: 2.148–9.707), and severe CSVD burden (OR = 3.818, 95% CI: 1.842–7.911). The nomogram exhibited excellent discrimination (AUC = 0.886) accompanied by satisfactory calibration (Hosmer-Lemeshow χ2 = 14.542, p = 0.104). Decision curve analysis showed clinical utility across threshold probabilities of 6–100%. Conclusion This validated nomogram incorporating clinical, biochemical, and neuroimaging biomarkers provides a robust tool for individualized PSCIND risk assessment in first-ever MIS patients, with potential to guide targeted interventions and cognitive monitoring.
Key findings
- Objective To identify significant predictors and construct a validated nomogram for predicting post-stroke cognitive impairment no dementia (PSCIND) risk among first-ever mild ischemic stroke (MIS) patients.
- Results Eight independent predictors were identified: age (OR = 1.060, 95% CI: 1.016–1.106), education level (OR = 0.917, 95% CI: 0.845–0.995), type 2 diabetes mellitus (OR = 9.407, 95% CI: 3.761–23.528), superoxide dismutase (OR = 0.951, 95% CI: 0.931–0.972), uric acid (OR = 1.006, 95% CI: 1.002–1.010), homocysteine (OR = 1.058, 95% CI: 1.027–1.091), strategic infarcts (OR = 4.566, 95% CI: 2.148–9.707), and severe CSVD burden (OR = 3.818, 95% CI: 1.842–7.911).
Why it matters
In 242 patients with first-ever mild ischemic stroke, eight predictors including age, education, type 2 diabetes, and severe cerebral small vessel disease burden were used to build a nomogram for predicting post-stroke cognitive impairment no dementia. This is a prediction tool for risk after stroke, not a treatment or prevention for Alzheimer's disease.
Study details
- Study designcohort study
- Participants137
- Effect sizeOR = 1.060; OR = 0.917; OR = 9.407
- Evidence strengthModerate
How this study scored 50/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Frontiers in Neurology) |
| Journal's citation record | 2 / 4 | Frontiers in Neurology: journal h-index 162 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 137 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 1.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Peiyuan Lv: h-index 19 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Hebei Normal University: institution h-index 249 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40904821) |
| Free to read | 2 / 2 | Free to read |
| Total | 50 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.3389/fneur.2025.1618953
- PubMed: 40904821
- Original source →
- Free full text: Frontiers in Neurology →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Teng, Z., Feng, J., Xie, X., Guan, T., Xu, J., Jiang, X., et al. (2025). A nomogram for predicting post-stroke cognitive impairment no dementia in patients with first-ever mild ischemic stroke. Frontiers in Neurology. https://doi.org/10.3389/fneur.2025.1618953
Vancouver
Teng Z, Feng J, Xie X, Guan T, Xu J, Jiang X, et al. A nomogram for predicting post-stroke cognitive impairment no dementia in patients with first-ever mild ischemic stroke. Frontiers in Neurology. 2025. doi:10.3389/fneur.2025.1618953. PMID: 40904821.
BibTeX
@article{teng2025-40904821,
author = {Teng, Zhenjie and Feng, Jing and Xie, Xiaohua and Guan, Tianyuan and Xu, Jing and Jiang, Xin and Chang, Yan-Zhong and Lv, Peiyuan},
title = {{A nomogram for predicting post-stroke cognitive impairment no dementia in patients with first-ever mild ischemic stroke}},
journal = {Frontiers in Neurology},
year = {2025},
doi = {10.3389/fneur.2025.1618953},
pmid = {40904821},
url = {https://doi.org/10.3389/fneur.2025.1618953}
}
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