Serum multi-trace elements and post-stroke cognitive impairment: a prospective observational cohort study

Abstract Post-stroke cognitive impairment (PSCI) significantly affects stroke survivors. Identifying modifiable risk factors for PSCI is essential. Serum multi-trace elements are crucial for neurological function but vary in concentration among older adults. It remains unclear whether increasing mul...

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Main Authors: Ruolin Zhou, Weijie Zhai, Lingjie Meng, Chunxiao Wei, Li Sun
Format: Article
Language:English
Published: Nature Publishing Group 2025-07-01
Series:Translational Psychiatry
Online Access:https://doi.org/10.1038/s41398-025-03420-5
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author Ruolin Zhou
Weijie Zhai
Lingjie Meng
Chunxiao Wei
Li Sun
author_facet Ruolin Zhou
Weijie Zhai
Lingjie Meng
Chunxiao Wei
Li Sun
author_sort Ruolin Zhou
collection DOAJ
description Abstract Post-stroke cognitive impairment (PSCI) significantly affects stroke survivors. Identifying modifiable risk factors for PSCI is essential. Serum multi-trace elements are crucial for neurological function but vary in concentration among older adults. It remains unclear whether increasing multi-trace elements can reduce the incidence of PSCI. We investigated the associations between baseline serum multi-trace elements and PSCI. The Montreal Cognitive Assessment defined PSCI. We used logistic regression analyses to evaluate the association between serum multi-trace elements and PSCI. Subsequently, we assessed the associations between serum multi-trace elements and three different cognitive domains using the Kruskal–Wallis test. We further evaluated improvements in the predictive ability of serum multi-trace elements. Finally, 626 patients (mean age: 62.85 ± 7.54 years) were followed up for a median of 1.2 years. Lower concentrations of serum iron (odds ratio [OR] = 2.498, 95% confidence interval [CI]: 1.505–4.145) and zinc (OR = 2.015, 95% CI: 1.233–3.293) were associated with a higher PSCI risk. Higher concentrations of serum iron (OR = 0.368, 95% CI: 0.227–0.595) and magnesium (OR = 0.273, 95% CI: 0.164–0.454), along with lower concentrations of serum copper (OR = 0.544, 95% CI: 0.34–0.872), were significantly correlated with a lower PSCI risk. Cognitive impairments varied across multi-trace elements. Serum iron affected wider cognition, while magnesium and copper levels were strongly associated with language and executive function. Adding serum multi-trace elements to the conventional model improved PSCI risk reclassification (area under curve: 0.676–0.718). Multi-trace elements may influence PSCI progression. This study was registered with the Chinese Clinical Trial Registry (URL: https://www.chictr.org.cn/ ; unique identifier: ChiCTR1900022675).
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spelling doaj-art-4035a070bd5c4ad29528d4f19397f0bf2025-08-20T03:45:36ZengNature Publishing GroupTranslational Psychiatry2158-31882025-07-011511810.1038/s41398-025-03420-5Serum multi-trace elements and post-stroke cognitive impairment: a prospective observational cohort studyRuolin Zhou0Weijie Zhai1Lingjie Meng2Chunxiao Wei3Li Sun4Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin UniversityDepartment of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin UniversityDepartment of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin UniversityDepartment of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin UniversityDepartment of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin UniversityAbstract Post-stroke cognitive impairment (PSCI) significantly affects stroke survivors. Identifying modifiable risk factors for PSCI is essential. Serum multi-trace elements are crucial for neurological function but vary in concentration among older adults. It remains unclear whether increasing multi-trace elements can reduce the incidence of PSCI. We investigated the associations between baseline serum multi-trace elements and PSCI. The Montreal Cognitive Assessment defined PSCI. We used logistic regression analyses to evaluate the association between serum multi-trace elements and PSCI. Subsequently, we assessed the associations between serum multi-trace elements and three different cognitive domains using the Kruskal–Wallis test. We further evaluated improvements in the predictive ability of serum multi-trace elements. Finally, 626 patients (mean age: 62.85 ± 7.54 years) were followed up for a median of 1.2 years. Lower concentrations of serum iron (odds ratio [OR] = 2.498, 95% confidence interval [CI]: 1.505–4.145) and zinc (OR = 2.015, 95% CI: 1.233–3.293) were associated with a higher PSCI risk. Higher concentrations of serum iron (OR = 0.368, 95% CI: 0.227–0.595) and magnesium (OR = 0.273, 95% CI: 0.164–0.454), along with lower concentrations of serum copper (OR = 0.544, 95% CI: 0.34–0.872), were significantly correlated with a lower PSCI risk. Cognitive impairments varied across multi-trace elements. Serum iron affected wider cognition, while magnesium and copper levels were strongly associated with language and executive function. Adding serum multi-trace elements to the conventional model improved PSCI risk reclassification (area under curve: 0.676–0.718). Multi-trace elements may influence PSCI progression. This study was registered with the Chinese Clinical Trial Registry (URL: https://www.chictr.org.cn/ ; unique identifier: ChiCTR1900022675).https://doi.org/10.1038/s41398-025-03420-5
spellingShingle Ruolin Zhou
Weijie Zhai
Lingjie Meng
Chunxiao Wei
Li Sun
Serum multi-trace elements and post-stroke cognitive impairment: a prospective observational cohort study
Translational Psychiatry
title Serum multi-trace elements and post-stroke cognitive impairment: a prospective observational cohort study
title_full Serum multi-trace elements and post-stroke cognitive impairment: a prospective observational cohort study
title_fullStr Serum multi-trace elements and post-stroke cognitive impairment: a prospective observational cohort study
title_full_unstemmed Serum multi-trace elements and post-stroke cognitive impairment: a prospective observational cohort study
title_short Serum multi-trace elements and post-stroke cognitive impairment: a prospective observational cohort study
title_sort serum multi trace elements and post stroke cognitive impairment a prospective observational cohort study
url https://doi.org/10.1038/s41398-025-03420-5
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