{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:28:29Z","timestamp":1792787309932,"version":"4.5.0"},"reference-count":35,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Key R&D Program of China","award":["2025YFE0214405"],"award-info":[{"award-number":["2025YFE0214405"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82572360"],"award-info":[{"award-number":["82572360"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2025M772293"],"award-info":[{"award-number":["2025M772293"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["GZC20251492"],"award-info":[{"award-number":["GZC20251492"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Beijing Tiantan Hospital, Capital Medical University","award":["2025-A07"],"award-info":[{"award-number":["2025-A07"]}],"id":[{"id":"https:\/\/ror.org\/013xs5b60","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Beijing Physician Scientist Training Project","award":["BJPSTPGD-2025-07"],"award-info":[{"award-number":["BJPSTPGD-2025-07"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Stroke Vasc Neurol"],"accepted":{"date-parts":[[2026,9,17]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The impact of cognitive reserve (CR) on poststroke cognitive impairment (PSCI) remains unclear. This study aimed to investigate the association between CR proxy scores derived from an education-residence proxy index and PSCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a post hoc analysis of the China Acute Ischemic Stroke Hypotension Trial II cohort including acute ischaemic stroke (AIS) patients without prior dementia who completed 3-month cognitive assessment. A CR proxy score was constructed using principal component analysis based on education and residential location. PSCI was defined as Montreal Cognitive Assessment &lt;25. Logistic regression and restricted cubic spline (RCS) analyses were used to examine associations between CR and PSCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PSCI occurred in 1019 of 1682 patients (60.6%). Higher CR proxy scores were associated with lower odds of PSCI (OR=0.88; 95% CI 0.81 to 0.96; p=0.01), with similar findings in the fully adjusted model (OR=0.89; 95% CI 0.81 to 0.98; p=0.02). RCS analyses showed a linear inverse association between CR proxy scores and PSCI (P overall=0.001; P non-linear=0.35). Component analyses suggested that educational attainment was the predominant contributor to the observed association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The education-residence-based CR proxy score was associated with lower odds of PSCI after AIS. The observed associations require cautious interpretation and further validation using comprehensive CR measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03479554\">NCT03479554<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/svn-2026-005809","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:15:15Z","timestamp":1791292515000},"page":"svn-2026-005809","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cognitive reserve and risk of poststroke cognitive impairment in acute ischaemic stroke: post hoc analysis of CATIS-2"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct03479554","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03479554","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5509-6439","authenticated-orcid":false,"given":"Minghua","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1822-7372","authenticated-orcid":false,"given":"Yufei","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zilin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8380-4076","authenticated-orcid":false,"given":"Ximing","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3527-9454","authenticated-orcid":false,"given":"Wanying","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1501-0351","authenticated-orcid":false,"given":"Lina","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe Kang","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuesong","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2943-055X","authenticated-orcid":false,"given":"Liping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"2026100606150990000_svn-2026-005809v1.1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-017-0779-7"},{"key":"2026100606150990000_svn-2026-005809v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70236-4"},{"key":"2026100606150990000_svn-2026-005809v1.3","doi-asserted-by":"crossref","first-page":"e272","DOI":"10.1161\/STR.0000000000000430","article-title":"Cognitive impairment after ischemic and hemorrhagic stroke: a scientific statement from the American Heart Association\/American Stroke Association","volume":"54","author":"El Husseini","year":"2023","journal-title":"Stroke"},{"key":"2026100606150990000_svn-2026-005809v1.4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.122.319951"},{"key":"2026100606150990000_svn-2026-005809v1.5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.13806"},{"key":"2026100606150990000_svn-2026-005809v1.6","doi-asserted-by":"crossref","DOI":"10.1016\/j.lanepe.2025.101428","article-title":"Risk factors for dementia and cognitive impairment within 5 years after stroke: a prospective multicentre cohort study","volume":"56","author":"Filler","year":"2025","journal-title":"Lancet Reg Health Eur"},{"key":"2026100606150990000_svn-2026-005809v1.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2018.07.219"},{"key":"2026100606150990000_svn-2026-005809v1.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2022.101814"},{"key":"2026100606150990000_svn-2026-005809v1.9","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13744"},{"key":"2026100606150990000_svn-2026-005809v1.10","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.3233\/JAD-131580","article-title":"Post-stroke cognitive impairment: high prevalence and determining factors in a cohort of mild stroke","volume":"40","author":"Jacquin","year":"2014","journal-title":"J Alzheimers Dis"},{"key":"2026100606150990000_svn-2026-005809v1.11","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.667618"},{"key":"2026100606150990000_svn-2026-005809v1.12","doi-asserted-by":"publisher","DOI":"10.1159\/000443649"},{"key":"2026100606150990000_svn-2026-005809v1.13","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.026829"},{"key":"2026100606150990000_svn-2026-005809v1.14","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13104"},{"key":"2026100606150990000_svn-2026-005809v1.15","first-page":"100687","article-title":"Incidence of post-stroke cognitive impairment in patients with first-ever ischemic stroke: a multicenter cross-sectional study in China","volume":"33","author":"He","year":"2023","journal-title":"Lancet Reg Health West Pac"},{"key":"2026100606150990000_svn-2026-005809v1.16","doi-asserted-by":"crossref","unstructured":"Gallucci L , Heldner MR , Sperber C , et al . Association of cognitive reserve with stroke outcome: a systematic review and meta-analysis. Int J Stroke 2026;17474930261417825. doi:10.1177\/17474930261417825","DOI":"10.1177\/17474930261417825"},{"key":"2026100606150990000_svn-2026-005809v1.17","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1136\/svn-2020-000828","article-title":"China Antihypertensive Trial in Acute Ischemic Stroke II (CATIS-2): rationale and design","volume":"6","author":"Liu","year":"2021","journal-title":"Stroke Vasc Neurol"},{"key":"2026100606150990000_svn-2026-005809v1.18","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2023-076448","article-title":"Early versus delayed antihypertensive treatment in patients with acute ischaemic stroke: multicentre, open label, randomised, controlled trial","volume":"383","author":"Liu","year":"2023","journal-title":"BMJ"},{"key":"2026100606150990000_svn-2026-005809v1.19","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1177\/17474930251401203","article-title":"Cognitive impairment in acute ischemic stroke patients with early versus delayed antihypertensive treatment: a prespecified analysis of CATIS-2 trial","volume":"21","author":"Wang","year":"2026","journal-title":"Int J Stroke"},{"key":"2026100606150990000_svn-2026-005809v1.20","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.044698"},{"key":"2026100606150990000_svn-2026-005809v1.21","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010418"},{"key":"2026100606150990000_svn-2026-005809v1.22","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30442-3"},{"key":"2026100606150990000_svn-2026-005809v1.23","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-019-09442-6"},{"key":"2026100606150990000_svn-2026-005809v1.24","doi-asserted-by":"crossref","DOI":"10.1002\/alz.70267","article-title":"Lifespan exposures to rural\u2013urban conditions and later\u2010life cognitive function","volume":"21","author":"Chu","year":"2025","journal-title":"Alzheimers Dement"},{"key":"2026100606150990000_svn-2026-005809v1.25","doi-asserted-by":"crossref","unstructured":"Liu F , Ding Y , Yu Y , et al . Residential trajectories, depressive symptoms and mild cognitive impairment in older adults: a longitudinal study from CHARLS. Int Psychogeriatr 2025;100165. doi:10.1016\/j.inpsyc.2025.100165","DOI":"10.1016\/j.inpsyc.2025.100165"},{"key":"2026100606150990000_svn-2026-005809v1.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2014.08.042"},{"key":"2026100606150990000_svn-2026-005809v1.27","doi-asserted-by":"crossref","DOI":"10.1002\/alz.70465","article-title":"Association and interaction of blood homocysteine and p\u2010tau217 levels with temporal cortical thinning and cognitive impairment in Alzheimer\u2019s disease","volume":"21","author":"Wang","year":"2025","journal-title":"Alzheimers Dement"},{"key":"2026100606150990000_svn-2026-005809v1.28","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.020827"},{"key":"2026100606150990000_svn-2026-005809v1.29","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1177\/1747493020984552","article-title":"Post-stroke cognitive impairment on the Mini-Mental State Examination primarily relates to left middle cerebral artery infarcts","volume":"16","author":"Weaver","year":"2021","journal-title":"Int J Stroke"},{"key":"2026100606150990000_svn-2026-005809v1.30","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1161\/STROKEAHA.122.042127","article-title":"Incremental value of stroke-induced structural disconnection in predicting global cognitive impairment after stroke","volume":"54","author":"Pan","year":"2023","journal-title":"Stroke"},{"key":"2026100606150990000_svn-2026-005809v1.31","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1177\/17474930241252530","article-title":"Strategic white matter hyperintensity locations associated with post-stroke cognitive impairment: a multicenter study in 1568 stroke patients","volume":"19","author":"Coenen","year":"2024","journal-title":"Int J Stroke"},{"key":"2026100606150990000_svn-2026-005809v1.32","doi-asserted-by":"crossref","DOI":"10.1002\/alz.70196","article-title":"Cognitive implications and associated transcriptomic signatures of distinct regional iron depositions in cerebral small vessel disease","volume":"21","author":"Wang","year":"2025","journal-title":"Alzheimers Dement"},{"key":"2026100606150990000_svn-2026-005809v1.33","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-313914"},{"key":"2026100606150990000_svn-2026-005809v1.34","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14910"},{"key":"2026100606150990000_svn-2026-005809v1.35","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-015-7776-6"}],"container-title":["Stroke and Vascular Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/svn-2026-005809","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:15:20Z","timestamp":1791292520000},"score":1,"resource":{"primary":{"URL":"https:\/\/svn.bmj.com\/lookup\/doi\/10.1136\/svn-2026-005809"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":35,"alternative-id":["10.1136\/svn-2026-005809"],"URL":"https:\/\/doi.org\/10.1136\/svn-2026-005809","relation":{},"ISSN":["2059-8688","2059-8696"],"issn-type":[{"value":"2059-8688","type":"print"},{"value":"2059-8696","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]}}}