Body mass index and cognitive recovery after acute ischemic stroke: A 3-month prospective analysis using mini-mental state examination at Tashkent Medical Academy, Uzbekistan

Background: The association between body mass index (BMI) and cognitive recovery after acute ischemic stroke (AIS) remains controversial, with some studies suggesting a protective effect of overweight status. This study aims to investigate the relationship between BMI and cognitive recovery at three months post-stroke using data from the clinic of Tashkent Medical Academy, Tashkent, Uzbekistan. Methods: We conducted a prospective cohort study including patients with AIS from the clinic of Tashkent Medical Academy between 2022 and 2024. Patients were categorized into five BMI groups based on World Health Organization (WHO) Asian population criteria. Cognitive recovery was assessed using the Mini-Mental State Examination (MMSE) at three months, with favorable recovery defined as an improvement of at least 3 points. Multivariate logistic regression and linear mixed-effects modeling (LMM) were used to evaluate the association between BMI and cognitive recovery, adjusting for demographic and clinical variables. were overweight, 30.0% had normal weight, 13.5% were obese, 4.4% were underweight, and 4.1% were severely obese. Favorable cognitive recovery was most frequent in overweight patients (60.9%) and least common in underweight patients (50.0%) (P < 0.001). Overweight status was independently associated with better cognitive recovery [odds ratio (OR): 1.22, 95% confidence interval (CI): 1.10-1.37], whereas severe obesity showed no statistically significant association with cognitive outcomes (OR: 1.06, 95% CI: 0.71-1.58). Conclusion: Overweight status may be associated with improved cognitive recovery after AIS, whereas severe obesity and underweight status are linked to worse outcomes. These findings highlight the need for individualized weight management strategies in post-stroke rehabilitation. Further research is needed to explore the underlying mechanisms and potential clinical interventions.

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