Association of combined physical and cognitive rehabilitation with post-stroke dementia: a U.S. multicenter retrospective cohort study.

Abstract

To compare the effectiveness of combined physical rehabilitation (PR) and cognitive rehabilitation (CR) versus PR alone in reducing the risk of developing post-stroke dementia DESIGN: Retrospective cohort study. U.S. TriNetX Collaborative Network, a multicenter federated electronic health record database. Adults aged ≥55 years diagnosed with stroke between January 1, 2010, and December 31, 2020, who developed MCI within 6 months after stroke. Patients were classified according to receipt of combined PR and CR or PR alone within six months after stroke. After 1:1 propensity score matching, 479 patients were included in each group. Not applicable. Incident post-stroke dementia occurring at least six months after index stroke. Compared with the PR-only group, the combined PR and CR group had a lower risk of post-stroke dementia (hazard ratio [HR], 0.58; 95% CI, 0.40-0.84). The association remained consistent across sensitivity analyses. Subgroup analyses showed similar associations among males and patients without intensive care unit stay during the index stroke hospitalization. Among older adults with post-stroke MCI, combined PR and CR was associated with a lower risk of incident post-stroke dementia compared with PR alone. These findings support the potential role of combined rehabilitation strategies in preserving long-term cognitive health after stroke.