Playing Mahjong for 12 Weeks Improved Executive Function in Elderly People With Mild Cognitive Impairment: A Study of Implications for TBI-Induced Cognitive Deficits

Transcutaneous Cervical Vagus Nerve Magnetic Stimulation in Patients With Traumatic Brain Injury: A Feasibility Study

OBJECTIVES

Transcutaneous vagus nerve stimulation has shown promising results in improving cognitive and motor function after stroke. However, to our knowledge, there have been no studies in the modulation of the cervical vagus nerve using repetitive transcranial magnetic stimulation (rTMS) in patients with traumatic brain injury (TBI) with cognitive dysfunction. Thus, we conducted a single-arm feasibility trial to assess the safety and effectiveness of rTMS of the vagus nerve in patients with TBI.

MATERIALS AND METHODS

We enrolled ten patients with TBI and administered half-hour vagus nerve magnetic stimulation (VNMS) sessions for ten days to evaluate the feasibility of the treatment. The Montreal cognitive assessment-Beijing (MoCA-B), the Digit Span Test, and the Auditory Verbal Learning Test (AVLT) were used to measure cognitive function before and after the VNMS treatment. Physiological parameters of all subjects were assessed by electrocardiogram.

RESULTS

The findings showed that daily half-hour VNMS for ten days was feasible in patients with TBI, with minimal side effects and no clinically significant effects on physiological parameters. Eight patients showed improvement in MoCA-B, and five patients showed improvement in immediate memory as measured by AVLT.

CONCLUSIONS

We conclude that VNMS is a safe and feasible treatment option for patients with TBI with cognitive dysfunction. However, further controlled studies are necessary to establish the efficacy of VNMS in promoting cognitive recovery after TBI.

SIGNIFICANCE

This study is, to our knowledge, the first study to investigate the feasibility of VNMS for cognitive dysfunction in patients with TBI. Our findings offer the possibility of rTMS applied to the vagus nerve in clinical practice.

Longitudinal associations between the frequency of playing Mahjong and cognitive functioning among older people in China: evidence from CLHLS, 2008-2018

Background

Cognitive decline is prevalent among older adults, often resulting in decreased capabilities for self-care and a diminished quality of life. Mahjong, a culturally cherished and extensively played intellectual game in China, demands considerable cognitive function. While the cognitive benefits of playing Mahjong have been widely accepted, this study investigates an under explored aspect and aimed to ascertain the game's potential contributions toward bolstering self-care abilities, enhancing overall quality of life, and mitigating against rising societal healthcare costs.

Methods

The data analyzed in the study is collected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) with cognitive functioning being assessed through the Mini-Mental State Examination (MMSE). The frequency of playing Mahjong was measured through a self-reported questionnaire. Multiple linear regression models, latent variable growth models, and cross-lagged models were used to investigate the longitudinal relationship between game frequency and cognitive function in older people.

Results

Of the 7,535 participants, the mean (SD) age was 81.96 (10.53) years. There were 7,308 (97%), 4,453 (59%), and 1,974 (26%) participants in 2011, 2014, and 2018, respectively. The results showed that Mahjong players had significantly higher MMSE scores compared to non-players from 2008 to 2018 (β = 0.893; p < 0.001), and non-players had significantly lower scores in 2011, 2014, and 2018 than in 2008 (β = -1.326, -0.912, -0.833; Ps > 0.05). Moreover, the frequency of playing Mahjong was associated with improved various cognitive domains. The declining frequency of playing Mahjong was substantially associated with the declining rate of MMSE scores (r = 0.336; p < 0.001). Mahjong frequency showed positive effects on MMSE scores, while the influence of Mahjong on MMSE scores were not significant.

Conclusion

Playing Mahjong has a positive influence on the cognitive functioning among older people. It can help buffer against the decline in cognitive function and maintain cognitive function levels. The higher frequency of playing Mahjong is associated with improved reaction, attention and calculation, and self-coordination. A decline in the frequency of playing Mahjong was associated with a declining rate of cognitive function. The higher frequency of playing Mahjong among older people unilaterally influenced the improvement of cognitive function levels in older people in China.

Predicting mild cognitive impairment among Chinese older adults: a longitudinal study based on long short-term memory networks and machine learning

Background

Mild cognitive impairment (MCI) is a transitory yet reversible stage of dementia. Systematic, scientific and population-wide early screening system for MCI is lacking. This study aimed to construct prediction models using longitudinal data to identify potential MCI patients and explore its critical features among Chinese older adults.

Methods

A total of 2,128 participants were selected from wave 5-8 of Chinese Longitudinal Healthy Longevity Study. Cognitive function was measured using the Chinese version of Mini-Mental State Examination. Long- short-term memory (LSTM) and three machine learning techniques, including 8 sociodemographic features and 12 health behavior and health status features, were used to predict individual risk of MCI in the next year. Performances of prediction models were evaluated through receiver operating curve and decision curve analysis. The importance of predictors in prediction models were explored using Shapley Additive explanation (SHAP) model.

Results

The area under the curve values of three models were around 0.90 and decision curve analysis indicated that the net benefit of XGboost and Random Forest were approximate when threshold is lower than 0.8. SHAP models showed that age, education, respiratory disease, gastrointestinal ulcer and self-rated health are the five most important predictors of MCI.

Conclusion

This screening method of MCI, combining LSTM and machine learning, successfully predicted the risk of MCI using longitudinal datasets, and enables health care providers to implement early intervention to delay the process from MCI to dementia, reducing the incidence and treatment cost of dementia ultimately.

The effect of the leisure activities based on chess and cards for improving cognition of older adults: study protocol for a cluster randomized controlled trial

BACKGROUND

With the increase in age, the probability of cognitive impairment in the older people is increasing. More and more evidence shows that participating in leisure activities, especially chess and cards, is beneficial to the cognition and mental state of the older people. But the evidence for causal inference is limited. There is a need to conduct a fully powered randomized controlled trial (RCT) and long-term follow-up to test the effectiveness of intervention measures in improving cognitive function and mental state. This paper describes the methodology of a cluster RCT designed to determine the effect of chess and cards leisure activities on the cognitive function of the older people over 60 years old.

METHODS/DESIGN

A cluster RCT consisting of 8 clusters will be conducted in four regions of Ningxia, China (Helan, Litong, Qingtongxia, and Shapotou). Clusters will be randomly assigned to the advocacy intervention group, which is also delivered with free leisure activities tools (chess and cards), or the control group. A baseline survey will be conducted before the intervention. A mid-term and final survey will be carried out twelve and twenty-four months after the intervention, respectively. The primary outcome is a change in cognitive function, and the secondary outcomes are changes in anxiety, depression, and loneliness.

DISCUSSION

The results of this RCT will be helpful to (1) confirm the effectiveness of chess and cards leisure activities in improving the cognitive function of the older people over 60 years old; (2) determine the relationship between the frequency and duration of chess and cards leisure activities and cognitive function; (3) provide evidence of promoting participation in leisure activities through education campaigns and free provision of chess and cards tools; and (4) provide valuable information for successful aging.

TRIAL REGISTRATION

Chinese Clinical Trial Registry: ChiCTR2200066817. Registered on 19 December 2022.

Sex differences in cognitive function among Chinese older adults using data from the Chinese longitudinal healthy longevity survey: a cross-sectional study

Objective

To compare the sex differences in cognitive function and its influencing factors among Chinese older adults.

Method

We conducted a cross-sectional study by using data from the China Longitudinal Healthy Longevity Survey (CLHLS). According to the 32 provinces and 4 municipalities directly under the Central Government of China, 3-5 counties or districts were randomly selected in each province or city (except Tibet), and then 1-3 villages or streets were randomly selected in each county or district, from which the target population was sampled. Mini Mental State Examination (MMSE) was used to assess the cognitive function of 9,262 older adults aged 65 and above in China. Descriptive analysis was applied to demonstrate the participants' demographic characteristics, health-related behaviors, social and non-social activity, disease status, mental and sleep condition. And then, univariate and multifactor analyses were performed to validate different risk factors for cognitive function, respectively in the general population, male older adults and female older adults.

Result

The older adults with cognitive impairment accounted for 10.4% of the total population. There are significant differences in cognitive function between male and female older adults. The odds of cognitive impairment in older adult women was 1.291 times that of older adult men (OR = 1.291, 95%CI: 1.084-1.538). Among the male older adults, those who were older, highly educated, spouseless, had depressive symptoms, and lacked social activities were more likely to have cognitive impairment, whereas among the female older adults, those who were older, highly educated, and lacked social activities were more likely to have cognitive impairment.

Conclusion

Overall, there are subtle differences in potential influencing factors for cognitive function between the male older adults and female older adults. Attention should be paid to the different cognitive protection measures for the older adults with different sexes.

Risk Factors of Progression to Cognitive Frailty: Singapore Longitudinal Ageing Study 2

INTRODUCTION

Cognitive frailty is associated with higher risk of dementia and adverse health outcomes. However, multidimensional factors that influence cognitive frailty transitions are not known. We aimed to investigate risk factors of incident cognitive frailty.

METHODS

Prospective cohort study participants were community-dwelling adults without dementia and other degenerative disorders and baseline and follow-up, including N = 1,054 participants aged ≥55 free of cognitive frailty at baseline, with complete baseline (March 6, 2009, to June 11, 2013) and follow-up data at 3-5 years later (January 16, 2013, to August 24, 2018). Incident cognitive frailty was defined by one or more criteria of the physical frailty phenotype and <26 of Mini-Mental State Examination (MMSE) score. Potential risk factors assessed at baseline included demographic, socioeconomic, medical, psychological and social factors, and biochemical markers. Data were analyzed using least absolute shrinkage selection operator (LASSO) multivariable logistic regression models.

RESULTS

A total of 51 (4.8%) participants, including 21 (3.5%) of the cognitively normal and physically robust participants, 20 (4.7%) of the prefrail/frail only, and 10 (45.4%) of cognitively impaired only, transited to cognitive frailty at follow-up. Risk factors for transition to cognitive frailty were having eye problem (OR = 2.6, 95% CI 1.24-5.43) and low HDL cholesterol (OR = 4.1, 95% CI 2.03-8.40), while protective factors for cognitive frailty transition were higher levels of education (OR = 0.3, 95% CI 0.10-0.74) and participation in cognitive stimulating activities (OR = 0.4, 95% CI 0.17-0.82).

CONCLUSION

Multi-domain modifiable factors especially related to leisure activities predict cognitive frailty transition and may be targeted for prevention of dementia and associated adverse health outcomes.

Pre exposure to enriched environment alleviates brain injury after ischemia-reperfusion by inhibiting p38MAPK/STAT1 pathway

BACKGROUND

Stroke is one of the major diseases that endangers human health. It is widely reported that enriched environment (EE) can improve the neurological function in different brain injury models. Recently, relevant researches have indicated that MAPK pathway is closely related to the inflammatory response in nervous system related diseases. However, whether pre exposure to EE (EE pretreatment) has a preventive effect, and its mechanism are not clear. Therefore, this study aimed to determine the possible benefits and related mechanisms of EE in preventing brain injury after acute ischemia-reperfusion.

METHODS

Adult Sprague Dawley rats were kept in enriched or standardized environments for 21 days. Then the middle cerebral artery of rats was occluded for one hour and 30 min, and then reperfusion was performed. Then their neurological deficit score was evaluated. Cerebral edema, along with ELISA and protein quantities of p38MAPK, JNK, ERK, IL-1β, TNF-α, and co-localization of Iba1 were assessed. Changes in neuroinflammation and apoptosis were also detected in the penumbra cortex.

RESULTS

Our research showed that EE pretreatment significantly alleviated acute cerebral ischemia-reperfusion injury in rats. Including the reduction of brain edema and apoptosis, and the improvement of neurological scores. In addition, the protein level of p38MAPK was significantly down regulated in EE pretreatment group, and the downstream protein STAT1 had the same trend. In addition, immunofluorescence results showed that Iba1 in EE pretreatment group decreased, the ELISA results showed that the classical proinflammatory cytokines increased significantly, while anti-inflammatory cytokines in EE pretreatment group increased, and the same results were obtained by Western blot analysis.

CONCLUSION

On the whole, our research demonstrated that EE pretreatment can have a protective effect on the organism by inhibiting the p38 MAPK/STAT1 pathway. Thus, EE can be one of the most promising means of disease prevention. Secondly, p38MAPK/STAT1 pathway may be a latent target for the prevention of acute ischemic stroke.

Can Traditional Board Games Prevent or Slow Down Cognitive Impairment? A Systematic Review and Meta-Analysis

BACKGROUND

Traditional board games can entail significant skills encompassing several cognitive functions across different domains. Therefore, they may potentially represent effective cognitive interventions in the aging population with or without Alzheimer's disease or other types of dementia.

OBJECTIVE

We aimed at verifying the hypothesis that traditional board games can prevent or slow down cognitive decline, through a systematic review on traditional board games and dementia.

METHODS

We searched five databases with tailored search strings. We included studies assessing the impact of board games on elderly subjects at risk of or suffering from cognitive impairment, or subjects with cognitive impairment irrespective of age. Studies where the effect of board games was not separated by cards or other games were excluded. A meta-analysis was performed for specific cognitive and non-cognitive outcomes.

RESULTS

Board games improved mental function, as measured by Montreal Cognitive Assessment (p = 0.003) and Mini-Mental State Examination (p = 0.02). Ska and Go improved Trail Making Test -A, while Mahjong improved executive functions. There was no consistent effect across different games on Digit Span or Categorical Fluency. Chess improved quality of life measured with the WHO-QoL-OLD scale (p < 0.00001). Mahjong temporarily improved depressive symptoms. Go increased BDNF levels and left middle temporal gyrus and bilateral putamen metabolism.

CONCLUSIONS

Traditional board games may slow global cognitive decline and improve the quality of life in elderly subjects. Different games have varying impacts on specific cognitive domains, possibly mediated by functional and biological factors.

Effect of Mahjong on children's intelligence quotient

This study investigated the effect of Mahjong, which is a table game played by three or four players and involves intellectual activity, on the intelligence quotient (IQ) of children. The participants were children between the age of 6 and 15 years, and their IQ was assessed immediately after enrolling in children's Mahjong classes and 1 year after the enrollment using the Wechsler Intelligence Scale for Children Fourth Edition (WISC-IV). Twenty children were included in the analysis. Their mean age at the time of the initial evaluation was 9 years and 6 months. In addition, we conducted a 1-year post-examination. The change in the IQ of this group was compared to that of a historical control group with a similar age range and test–retest interval. The mean overall full-scale IQ of the 20 children during the initial and post-1-year examinations was 106.05 and 113.75, respectively, and showed a statistically significant increase (p < 0.01). Based on the subscale index, the verbal comprehension index (VCI) and processing speed index (PSI) scores both showed a statistically significant increase from 100.6 to 106.75 and from 108.05 to 119.05 (p < 0.01), respectively. The PSI of the children included in the analysis showed a statistically significant increase compared to the historical control group. This study suggests that children who participate in Mahjong classes during their childhood have increased PSI scores of WISC-IV.

Using machine learning algorithms for predicting cognitive impairment and identifying modifiable factors among Chinese elderly people

Objectives: This study firstly aimed to explore predicting cognitive impairment at an early stage using a large population-based longitudinal survey of elderly Chinese people. The second aim was to identify reversible factors which may help slow the rate of decline in cognitive function over 3 years in the community. Methods: We included 12,280 elderly people from four waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), followed from 2002 to 2014. The Chinese version of the Mini-Mental State Examination (MMSE) was used to examine cognitive function. Six machine learning algorithms (including a neural network model) and an ensemble method were trained on data split 2/3 for training and 1/3 testing. Parameters were explored in training data using 3-fold cross-validation and models were evaluated in test data. The model performance was measured by area-under-curve (AUC), sensitivity, and specificity. In addition, due to its better interpretability, logistic regression (LR) was used to assess the association of life behavior and its change with cognitive impairment after 3 years. Results: Support vector machine and multi-layer perceptron were found to be the best performing algorithms with AUC of 0.8267 and 0.8256, respectively. Fusing the results of all six single models further improves the AUC to 0.8269. Playing more Mahjong or cards (OR = 0.49,95% CI: 0.38-0.64), doing more garden works (OR = 0.54,95% CI: 0.43-0.68), watching TV or listening to the radio more (OR = 0.67,95% CI: 0.59-0.77) were associated with decreased risk of cognitive impairment after 3 years. Conclusions: Machine learning algorithms especially the SVM, and the ensemble model can be leveraged to identify the elderly at risk of cognitive impairment. Doing more leisure activities, doing more gardening work, and engaging in more activities combined were associated with decreased risk of cognitive impairment.

Association of Playing Cards or Mahjong with Cognitive Function in Chinese Older Adults

Cognitive decline in older adults is a major public health threat. This study aimed to explore the association of participation in cards or mahjong with cognitive function in older adults. A total of 7308 older adults were selected from the 2018 Chinese Longitudinal Healthy Longevity Survey. A modified Mini-Mental State Examination (MMSE) was used to assess cognitive function. The participants were classified according to the frequency of playing cards or mahjong into the “regularly” (R) group, “occasionally” (O) group, or “never” (N) group. The results showed that older persons in the R group and O group had better cognitive function than those in the N group. Specifically, significant differences were found in attention and calculation, language, and total MMSE score between the R group and the N group. However, significant differences were not observed for adults aged 60–69 years old. Regression analysis indicated that playing cards or mahjong, together with age, educational level, sex, marital status, and occupation before age 60 could explain the cognitive function. The findings suggest that there is an association between participation in cards or mahjong and cognitive function in the population of Chinese older adults, and that the frequency of participation plays an important role in the association.

A Proposal of Cognitive Intervention in Patients with Alzheimer's Disease through an Assembling Game: A Pilot Study

(1) Background: Alzheimer’s disease is an irreversible brain disease, and current treatments are aimed at fighting cognitive decline. We have explored the feasibility of a game-based intervention for people with moderate Alzheimer’s disease; (2) Methods: Six participants, five women and one man, were recruited from a day center to participate in a five-week study, which included a re- and post-evaluation with the Montreal Cognitive Assessment (MoCA) and INECO Frontal Screening (IFS) tests. Three participants were assigned to the control group and three others to the experimental one. Both groups performed a play activity consisting of assembling a pie toy. Participants in the experimental group were asked to make a pie matching a sample after a time interval. Control group participants were asked to freely assemble a pie without the matching component; (3) Results: Patients were shown to be motivated during such an activity during the nine sessions. The experimental group showed a significant increase in IFS scores when comparing the post- and pre-intervention assessments. No significant differences were observed in MoCA scores; (4) The intervention created a social and emotional climate suitable to maintaining participants’ satisfaction and motivation, as well as to developing executive function while promoting positive emotions.

Relationships of leisure activities with physical and cognitive functions among Chinese older adults: A prospective community-based cohort study

OBJECTIVES

Based on a prospective design, this study aimed to investigate the relationships of leisure activities with physical and cognitive functions among Chinese older adults.

METHODS

The respondents aged 65 years or more were selected from the 2014-2018 of the Chinese Longitudinal Healthy Longevity Survey. Physical function measurement indicators were reflected by activities of daily living (ADL), instrumental activities of daily living (IADL), and physical performance (PP), while cognitive function was assessed by Mini-Mental State Examination. Fine-Gray competing risk regression models were used to analyze the data.

RESULTS

Using the figures for 2014 as a baseline for the study, we included 6047, 6216, 5951, and 5916 respondents in the ADL, IADL, PP, and cognitive function analyses, respectively. The prospective results showed that keeping domestic animals or pets was related to a lower risk of ADL disability of respondents after adjustment (SHR: 0.619, 95% CI: 0.486, 0.788). Similarly, taking part in social activities (SHR: 0.781, 95%CI: 0.658, 0.929) and reading books or newspapers (SHR: 0.793, 95% CI: 0.656, 0.958) were associated with a lower risk of IADL disability. Playing cards or mahjong was correlated with a lower risk of cognitive impairment (SHR: 0.669, 95% CI: 0.507, 0.882), while keeping domestic animals or pets was related to a higher risk of cognitive impairment (SHR: 1.279, 95% CI: 1.047, 1.562).

CONCLUSION

Participation in leisure activities moderately may decrease the risk of a decline in physical and cognitive functions among Chinese older adults.

Effects of Tabletop Games on Cognition in Older Adults: A Systematic Review and Meta-Analysis

Studies have shown that leisure activities, such as tabletop games, not only increase social interactions and reduce depression among older adults, but also help improve their cognitive function. However, the effects of tabletop games on cognition in older adults are yet to be comprehensively analyzed. The purpose of this study was to review and examine the effects of tabletop games on cognition in older adults. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were searched in seven electronic databases from their inception to December 2020. A total of 3946 studies were retrieved, among which 11 studies were systematically reviewed and 10 were meta-analyzed. In older adults with intact cognition, tabletop games had positive effects on their global cognition (standardized mean differences [SMD] = 1.36, 95% confidence intervals [CI]: 0.37-2.34, P < 0.001) and executive function (SMD = 0.47, 95% CI: 0.12-0.83, P < 0.001). In older adults with cognitive impairment, significant differences were found in global cognition (SMD = 0.53, 95% CI: 0.09-0.98, P = 0.02). Tabletop games had the characteristics of cognitive training and interpersonal interactions. After receiving tabletop game interventions, the cognitive functioning in older adults with intact cognition and those with mild cognitive impairment or dementia was improved. For older adults, in addition to improving cognitive functioning, tabletop games also increased their social participation and interactions. Systematic Review Registration: This review has been registered in the PROSPERO (CRD42021254085).

The Effect of Repetitive Transcranial Magnetic Stimulation (rTMS) on Cognition in Patients With Traumatic Brain Injury: A Protocol for a Randomized Controlled Trial

Cognitive impairment, defined as a decline in memory and executive function, is one of the most severe complications of traumatic brain injury (TBI). Patients with TBI are often unable to return to work due to cognitive impairment and their overall quality of life is reduced. TBI can bring a serious economic burden to patient's families and to society. Reported findings on the efficacy of repetitive transcranial magnetic stimulation (rTMS) in improving cognitive impairment following TBI are inconsistent. The purpose of the proposed study is to investigate whether rTMS can improve memory and executive function in patients with TBI. Herein, we propose a prospective randomized placebo-controlled (rTMS, sham rTMS, cognitive training), parallel-group, single-center trial. 36 participants with a TBI occurring at least 6 months prior will be recruited from an inpatient rehabilitation center. Participants will be randomly assigned to the real rTMS, sham rTMS, or cognitive training groups with a ratio of 1:1:1. A 20-session transcranial magnetic stimulation protocol will be applied to the left and right dorsolateral prefrontal cortices (DLPFC) at frequencies of 10 Hz and 1 Hz, respectively. Neuropsychological assessments will be performed at four time points: baseline, after the 10th rTMS session, after the 20th rTMS session, and 30 days post-intervention. The primary outcome is change in executive function assessed using the Shape Trail Test (STT). The secondary outcome measures are measures from neuropsychological tests: the Hopkins Verbal Learning Test (HVLT), the Brief Visuospatial Memory Test (BVMT), the Digit Span Test (DST). We report on positive preliminary results in terms of improving memory and executive function as well as beneficial changes in brain connectivity among TBI patients undergoing rTMS and hypothesize that we will obtain similar results in the proposed study.

Pathogeny Detection for Mild Cognitive Impairment via Weighted Evolutionary Random Forest with Brain Imaging and Genetic Data

Medical imaging technology and gene sequencing technology have long been widely used to analyze the pathogenesis and make precise diagnoses of mild cognitive impairment (MCI). However, few studies involve the fusion of radiomics data with genomics data to make full use of the complementarity between different omics to detect pathogenic factors of MCI. This paper performs multimodal fusion analysis based on functional magnetic resonance imaging (fMRI) data and single nucleotide polymorphism (SNP) data of MCI patients. In specific, first, using correlation analysis methods on sequence information of regions of interests (ROIs) and digitalized gene sequences, the fusion features of samples are constructed. Then, introducing weighted evolution strategy into ensemble learning, a novel weighted evolutionary random forest (WERF) model is built to eliminate the inefficient features. Consequently, with the help of WERF, an overall multimodal data analysis framework is established to effectively identify MCI patients and extract pathogenic factors. Based on the data of MCI patients from the ADNI database and compared with some existing popular methods, the superiority in performance of the framework is verified. Our study has great potential to be an effective tool for pathogenic factors detection of MCI.

Effect of Cognitive Function on Balance and Posture Control after Stroke

Hemiplegic gait is the most common sequela of stroke. Patients with hemiplegic gait are at a risk of falling because of poor balance. The theory of cognitive-motor networks paved the way for a new field of research. However, the mechanism of the relationship of cognition with gait or posture control networks is unclear because of the dynamic characteristics of walking and changing postures. To explore differences in the balance function and fall risk between patients with and without cognitive impairment after stroke, we utilized the Berg balance scale, Timed “Up and Go” test, and 10 m walking test. Patients were divided into two groups: the observation group (16 patients, female 6 and male 10), comprising patients with cognitive impairment after stroke, and the control group (16 patients, female 7 and male 9), comprising patients without cognitive impairment after stroke. We found that patients with cognitive impairment had worse balance function and a higher risk of falls. They needed a longer time to turn around or sit down. Our findings indicated that posture control in turning around and sitting down required more cognitive resources in daily life.