BMJ Open. 2026 May 11;16(5):e111625. doi: 10.1136/bmjopen-2025-111625.
ABSTRACT
OBJECTIVES: This study examines the prevalence of and risk factors associated with cognitive impairment among Indian stroke survivors aged ≥60 using data from the Longitudinal Ageing Study in India (LASI).
DESIGN: Cross-sectional comparative analysis.
SETTING: Secondary analysis of Wave 1 (2017-2019) data from the nationally representative LASI.
PARTICIPANTS: A total of 844 individuals aged ≥60 years with a self-reported history of stroke and 2532 age-matched and gender-matched non-stroke controls selected at a 3:1 ratio from the LASI dataset.
OUTCOME MEASURES: The outcome measure was the prevalence of cognitive impairment among older adults with a history of stroke, assessed using a composite cognitive index (score ≤14) derived from five cognitive domains. We also aimed to identify socio-demographic, socioeconomic, behavioural and health-related factors associated with post-stroke cognitive impairment using multivariable logistic regression models.
RESULTS: Stroke survivors had a higher prevalence of cognitive impairment (15.3%) compared with non-stroke individuals (11.6%) and significantly lower cognitive function (composite score: 22.23 vs 23.78, p<0.001). Stroke significantly increased the risk of cognitive impairment (OR 1.37, 95% CI 1.05 to 1.79, p=0.021), even after adjusting for demographic and health-related factors. Higher expenditure status, higher education and urban residence were strong protective factors, while being single and experiencing depressive symptoms were associated with an increased likelihood of cognitive impairment. Based on a multivariate-adjusted model, risk factors for cognitive impairment among stroke survivors included advanced age (OR 3.54, 95% CI 1.35 to 9.27, p=0.010 (80+ vs 60-64 years)), female gender (2.53, 95% CI 1.32 to 4.86, p=0.005), physical inactivity (1.93, 95% CI 1.03 to 3.61, p=0.039), not in a current relationship (2.08, 95% CI 1.10 - 3.93, p= 0.024) and being underweight (2.97, 95% CI 1.47 to 6.00, p=0.002).
CONCLUSION: Stroke survivors in India face increased risk of cognitive impairment, with associated risk factors including age, female gender, inactivity, depression and low body mass index, while higher education and expenditure status were associated with a reduced risk. Early detection and targeted interventions, including screening, lifestyle changes and personalised rehabilitation, are vital for preserving cognitive health after stroke.
PMID:42114870 | DOI:10.1136/bmjopen-2025-111625