ArticleFrontiers in medicine2026
Joint trajectories of sleep quality and cognitive function after acute ischemic stroke: a prospective cohort study using group-based dual trajectory modeling.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Sleep disorders and cognitive impairment commonly co-occur after acute ischemic stroke (AIS), yet their co-development is rarely modeled jointly. Objective: To determine whether sleep quality and cognitive function after AIS show asynchronous rather than automatically parallel recovery trajectories during the first year after discharge, and to identify distinct joint trajectory subgroups and baseline factors associated with trajectory membership. Methods: In this single-center prospective cohort in Shanghai (December 2023-October 2024), AIS inpatients were assessed within 24 h before discharge (T1) and at 3 (T2) and 12 months (T3). Sleep quality (PSQI; reverse-coded for modeling) and cognition (MoCA) were jointly modeled using group-based dual trajectory modeling (GBDTM). The optimal class solution was selected using information criteria and classification quality. Multinomial logistic regression (C1 reference) examined predictors of class membership. Generalized estimating equations (GEE) evaluated longitudinal changes in NIHSS, Barthel Index, IADL, and PHQ-9 across classes. Results: Among 515 participants, a 3-class solution was optimal: C1 sleep improvement-cognitive decline (29.51%, Conclusion: AIS survivors show heterogeneous and sometimes asynchronous joint sleep-cognition trajectories. Joint trajectory stratification and its correlates may inform targeted follow-up and individualized management.
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