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Lijun Zuo,1,&ast; Yanhong Dong,2,&ast; Xiaoling Liao,1 Yang Hu,1 Yuesong Pan,3 Hongyi Yan,3 Xingao Wang,1 Xingquan Zhao,1 Yilong Wang,1 Raymond CS Seet,4,5 Yongjun Wang,1,3 Zixiao Li1,3,6– 8 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Clinical Research Centre, Singapore; 3China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 4Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 5Division of Neurology, Department of Medicine, National University Hospital, Singapore; 6Beijing Tiantan Hospital, Capital Medical University, and the Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 7National Center for Healthcare Quality Management in Neurological Diseases, Beijing, People’s Republic of China; 8Chinese Institute for Brain Research, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zixiao Li, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119, South 4th Ring West Road, Fengtai District, Beijing, 100070, People’s Republic of China, Email lizixiao2008@hotmail.comObjective: The HALP (hemoglobin, albumin, lymphocyte, and platelet) score is a novel indicator that measures systemic inflammation and nutritional status that has not been correlated with the risk of post-stroke cognitive impairment in patients with acute ischemic stroke or transient ischemic attack (TIA).Methods: Study participants were recruited from 40 stroke centers in China. The HALP score was derived using a weighted sum of hemoglobin, albumin, lymphocytes and platelets, and study participants were categorized into 4 groups of equal sizes based on quartiles cutoffs of the HALP score. The Montreal Cognitive Assessment (MoCA)-Beijing Cognitive Assessment Scale (MoCA-Beijing) was performed at 2 weeks and 12 months following stroke onset. Post-stroke cognitive impairment was considered in patients with MoCA-Beijing≤ 22. Multiple logistic regression methods were employed to evaluate the relationship between the HALP score and the subsequent risk of developing post-stroke cognitive impairment.Results: The study population comprised 1022 patients (mean age 61.6± 11.0 years, 73% men). The proportion of individuals with MoCA-Beijing≤ 22 at 2 weeks was 49.2% and 32.4% at one year. Patients in the lowest quartile of HALP score (< 36.56) were observed to harbor the highest risk of post-stroke cognitive impairment at 12 months post-stroke/TIA compared to those in the highest quartile (odds ratio=1.59, 95% CI=1.07– 2.37, p=0.022), and lower domain scores for executive function, naming, and attention. There were no statistically significant differences between patients in the different quartiles of HALP score and HALP score at 2 weeks post-stroke/TIA.Conclusion: The HALP score is a simple score that could stratify the risk of post-stroke cognitive impairment in stroke/TIA patients to facilitate early diagnosis and interventions.Keywords: mild stroke, post stroke cognitive impairment, hemoglobin, albumin, lymphocyte, platelet