Objectives: This study aimed to investigate the relationship between the anticoagulation and risk factors in atrial fibrillation (ATRIA) score and initial stroke severity in patients with acute ischemic stroke of varying etiologies, including atrial fibrillation (AF), large-artery atherosclerosis, and undetermined origin. Methods: In this prospective observational study, 416 patients admitted with acute ischemic stroke between June 2022 and December 2024 were analyzed. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), and patients were categorized into two groups: mild-to-moderate (NIHSS ≤ 15) and moderate-to-severe/severe (NIHSS > 15). Pre-admission ATRIA scores were calculated based on demographic and clinical parameters. Multivariable logistic regression was performed to assess the association between ATRIA scores and stroke severity. Results: Patients with more severe strokes had significantly higher ATRIA scores (median 8.5 vs. 5.0, p < 0.001). AF was more frequent in the severe group (44.8% vs. 31.3%, p = 0.037). In multivariable analysis, each one-point increase in the ATRIA score was independently associated with a 1.82-fold increase in the odds of severe stroke (OR 1.823, 95% CI 1.568–2.119, p < 0.001). High ATRIA scores (>6) were associated with an 11.7-fold increased risk of severe stroke (OR 11.692, 95% CI 5.636–24.255, p < 0.001), independent of stroke etiology, ejection fraction, and inflammatory markers. Conclusions: The ATRIA score is independently associated with initial stroke severity across diverse ischemic stroke etiologies. It may serve as a simple, practical tool for early risk stratification in the acute setting, regardless of AF status. Further studies are warranted to confirm its utility in guiding early management and prognosis.

Aim: Vascular cognitive impairment (VCI), which affects many people, is important to distinguish from other types of cognitive impairment because vascular risk factors can slow disease onset and progression. In our study, we aimed to determine the most appropriate cognitive screening tool for vascular cognitive impairment. Methods: This study included 110 patients with mild VCI and a control group of 90 volunteers aged over 55 and was conducted between July 2024 and September 2025. Mild VCI was diagnosed according to DSM-5 criteria. We administered the Montreal Cognitive Assessment (MoCA), the Standardized Mini-Mental State Examination (MMSE), and Addenbrooke’s Cognitive Examination Test (ACE-R) to all participants. Results: Our findings demonstrate that all three screening tools significantly differentiate patients with mild VCI from healthy controls. ACE-R had the highest area under the curve (AUC = 0.967) and showed 90% sensitivity and 100% specificity at a cut-off of 68.5. MoCA also showed relatively high sensitivity (86.4%) and specificity (91.1%), with high diagnostic accuracy (AUC = 0.946). In contrast, the MMSE showed a slightly lower diagnostic performance (AUC = 0.926) but still had high specificity (92.2%). Conclusions: Our study demonstrates that the ACE-R is the most accurate screening tool for detecting mild vascular cognitive impairment, with the MoCA trailing by a very small margin, while the MMSE may be less sensitive in the early stages. Given the administration time, the MoCA can be a quicker alternative to the ACE-R.

Aim: Vascular cognitive impairment (VCI), which affects many people, is important to distinguish from other types of cognitive impairment because vascular risk factors can slow the onset and progression of the disease. In our study, we aimed to determine the most appropriate cognitive screening tool. Methods: The study included 110 patients with minor VCI and a control group of 90 volunteers aged over 55 and was conducted between July 2024 and September 2025. The diagnosis of mild VCI was determined according to DSM-5 criteria. The Montreal Cognitive Assessment (MoCA), the Standardized Mini-Mental State Examination (MMSE), and the Addenbrooke's Cognitive Examination Test (ACE-R) were administered to all participants. Results: Our findings demonstrate that all three screening tools significantly differentiate patients with mild VCI from healthy controls. ACE-R had the highest area under the curve (AUC=0.967) and showed 90% sensitivity and 100% specificity at a cutoff point of 68.5. MoCA also showed relatively high sensitivity (86.4%) and specificity (91.1%), with high diagnostic accuracy (AUC = 0.946). In contrast, MMSE showed slightly lower diagnostic performance (AUC=0.926) but still had high specificity (92.2%). Conclusion: Our study shows that ACE-R is the most accurate screening tool for detecting mild vascular cognitive impairment, closely followed by MoCA, while MMSE, though useful, may be less sensitive in the early stages. Further studies involving larger, multicenter cohorts and different subtypes of vascular cognitive impairment are needed.