Clinical Interventions in Aging (Dec 2018)
Association between vitamin D status and cognitive impairment in acute ischemic stroke patients: a prospective cohort study
Abstract
Huijun Chen,1,* Yuntao Liu,1,* Guiqian Huang,1,* Jie Zhu,2 Wenqian Feng,2 Jincai He1 1Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; 2Department of Mental Health, Mental Health School, Wenzhou Medical University, Wenzhou 325000, China *These authors contributed equally to this work Objective: Previous studies found that low vitamin D levels were modestly associated with risk of stroke and poor functional outcome after stroke. In addition, vitamin D deficiency has been linked with cognitive decline. Our study aimed to explore the potential relationship between vitamin D levels in the short-term acute phase of ischemic stroke and cognitive impairment at 1 month. Methods: In total, 354 ischemic stroke patients were consecutively enrolled in the study and received 1-month follow-up. The serum levels of vitamin D were measured within 24 hours after admission. Cognitive function was evaluated by the Mini-Mental State Examination (MMSE) at 1 month after acute ischemic stroke. Cognitive impairment was defined according to different education levels. Results: According to MMSE scores, 114 participants (32.2%) had cognitive impairment at 1 month. Patients with vitamin D deficiency were more likely to have cognitive impairment than those with vitamin D insufficiency and vitamin D sufficiency (P<0.001). After adjusting for potential confounders in our Cox proportional hazards model, vitamin D deficiency was independently associated with the development of cognitive impairment in acute ischemic stroke patients. Conclusion: Independent of established risk factors, vitamin D deficiency in the short-term phase of ischemic stroke was associated with a higher incidence of 1-month cognitive impairment. Keywords: vitamin D, cognitive impairment, ischemic stroke, Mini-Mental State Examination
