High Fibrinogen Levels Linked to Cognitive Decline in Ischemic Cerebrovascular Disease Patients: Study

A recent study published in the Journal of Stroke and Cerebrovascular Diseases identified fibrinogen as a potential contributor to cognitive decline in patients with ischemic cerebrovascular disease (ICVD). The findings suggest that elevated fibrinogen levels are significantly associated with an increased risk of cognitive impairment, particularly affecting global cognition and visuospatial/executive functions.

This case-control analysis at a neurology department explored the relationship between fibrinogen and cognitive function, as well as the role of brain abnormalities like white matter hyperintensities (WMH) and brain atrophy. Keying Wu and team assessed cognitive function using the Montreal Cognitive Assessment (MoCA) and examined brain structure using magnetic resonance imaging (MRI).

The results revealed a striking correlation between fibrinogen levels and cognitive impairment. For each unit increase in fibrinogen, the risk of cognitive impairment nearly doubled (Adjusted Odds Ratio [AOR] = 1.92, 95% Confidence Interval [CI] = 1.06 - 3.48). Moreover, individuals with fibrinogen levels exceeding 4 g/L faced a 5.72 times higher risk of cognitive impairment when compared to the patients with levels between 2 and 4 g/L.

Further analysis showed a negative correlation between fibrinogen levels and overall cognitive function (rs = -0.235) as well as visuospatial/executive function (rs = -0.251). Visuospatial/executive function is crucial for skills like planning, problem-solving, and spatial awareness, which are commonly affected in vascular dementia (VaD) and other cognitive disorders.

MRI scans provided additional evidence of fibrinogen’s impact on brain health. This study observed a negative correlation between fibrinogen and normal-appearing white matter (NAWM) volume (rs = -0.282). This suggests that higher fibrinogen levels might contribute to white matter damage, a known risk factor for cognitive decline and dementia.

White matter hyperintensities (WMH), often linked to small vessel disease and brain aging, were also evaluated. Although the study does not establish causation, the data strongly suggest that fibrinogen may influence cognitive decline through its effects on white matter integrity.

These findings underline the importance of fibrinogen as a potential biomarker for cognitive decline in ICVD patients. Given its role in blood clotting and vascular health, excessive fibrinogen might contribute to chronic brain injury through inflammation, microvascular damage, and reduced blood flow. Overall, the study highlights the need for further research to explore whether reducing fibrinogen levels could help preserve cognitive function in individuals at risk for vascular dementia.

Source:

Wu, K., Wang, J., Li, X., Xin, Z., Wang, W., Guo, L., He, F., Jiang, B., Kang, C., Xie, Y., Li, Q., Wang, X., & Lu, C. (2025). Association between fibrinogen and cognitive impairment in patients with ischemic cerebrovascular disease. Journal of Stroke and Cerebrovascular Diseases: The Official Journal of National Stroke Association, 108227, 108227. https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108227