Vitamin D Status and Cognitive Performance of Post Stroke Patients

Rizaldy Pinzon, Vincent Ongko Wijaya, Dessy Paramitha

Abstract


Background: The prevalence of post-stroke cognitive impairment (PSCI) ranges from 20-80%. Some studies found that vitamin D deficiency was common in stroke patients, yet the relationship with cognitive performance remains unclear. The study aimed to investigate the relationship between levels of vitamin D and cognitive performance in post-stroke patients.

Materials and Methods: This was a cross-sectional study with 20 post-ischemic stroke patients. Vitamin D levels were measured using enzyme-linked fluorescent assay (ELFA). The cognitive performance was assessed by computerized mini-mental state examination (MMSE) and clock drawing test (CDT). The relationship between vitamin D levels and cognitive tests were performed using paired T-test.

Results: Vitamin D insufficiency (<30 ng/mL) was experienced by all of the study subjects (100%), with the mean±SD of vitamin D level was 13.75±4.06 ng/mL. More than 70% subjects had cognitive impairment. Based on MMSE, patients with cognitive impairment had lower vitamin D levels, compared with those patients with normal cognition (13±4.38 vs. 16±2.44 ng/mL, p<0.001). In CDT examination, patients with cognitive impairment had slightly higher vitamin D levels, compared with those patients with normal cognition (13.93±4.25 vs. 13.33±3.93 ng/mL, p<0.001).

Conclusion: The insufficiency of vitamin D on post-ischemic stroke patients appears to generate a bigger chance of PSCI occurrence. Physicians should be aware of vitamin D status of post-stroke patients, especially in the older population.

Keywords: vitamin D levels, post-stroke cognitive impairment, risk factors


Full Text:

PDF

References


Fidan F, Alkan BM, Tosun A. Pandemic era: vitamin D deficiency and insufficiency. Turkish Journal of Osteoporosis. 2014; 20(2): 71-4, CrossRef.

Sizar O, Khare S, Goyal A, Bansal P, Givler A. Vitamin D deficiency. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020, article.

Kementerian Kesehatan. Indonesian Based Health Survey/Riset Kesehatan Dasar Indonesia 2018. Jakarta: Kementerian Kesehatan; 2018, article.

Narasimhan S. Role of vitamin D in the outcome of ischemic stroke: a randomized controlled trial. J Clin Diagn Res. 2017; 11(2): CC06-CC10, CrossRef.

Wei ZN, Kuang JG. Vitamin D deficiency in relation to the poor functional outcomes in nondiabetic patients with ischemic stroke. Biosci Rep. 2018; 38(2): BSR20171509, CrossRef.

Turetsky A, Goddeau RP Jr, Henninger N. Low serum vitamin D is independently associated with larger lesion volumes after ischemic stroke. J Stroke Cerebrovasc Dis. 2015; 24(7): 1555-63, CrossRef.

Anastasiou CA, Yannakoulia M, Scarmeas N. Vitamin D, and cognition: an update of the current evidence. JAD. 2014; 42(3): S71-80, CrossRef.

Sallam K, Amr M. The use of the mini-mental state examination and the clock-drawing test for dementia in a tertiary hospital. J Clin Diagn Res. 2013;7(3): 484-488, CrossRef.

Nair R, Maseeh A. Vitamin D: The "sunshine" vitamin. J Pharmacol Pharmacother. 2012; 3(2): 118‐26, CrossRef.

Berghout BP, Fani L, Heshmatollah A, Koudstaal PJ, Kram MA, Zillikens MC, et al. Vitamin D status and risk of stroke: The Rotterdam Study. Stroke. 2019; 50(9): 2293-8, CrossRef.

Moretti R, Morelli ME, Caruso P. Vitamin D in neurological diseases: a rationale for a pathogenic impact. Int J Mol Sci. 2018; 19(8): 2245, CrossRef.

Chen Y, Liu W, Sun T, Huang Y, Wang Y, Deb DK, et al. 1,25-dihydroxy vitamin D promotes negative feedback regulation of TLR signaling via targeting microRNA-155-SOCS1 in macrophages. J Immunol. 2013; 190(7): 3687-95, CrossRef.

Takeda M, Yamashita T, Sasaki N, Nakajima K, Kita T, Shinohara M, et al. Oral administration of an active form of vitamin D3 (calcitriol) decreases atherosclerosis in mice by inducing regulatory T cells and immature dendritic cells with tolerogenic functions. Arterioscler Thromb Vasc Biol. 2010; 30(12): 2495-503, CrossRef.

Chen H, Liu Y, Huang G, Zhu J, Feng W, He J. Association between vitamin D status and cognitive impairment in acute ischemic stroke patients: a prospective cohort study. Clin Interv Aging. 2018; 13: 2503-9, CrossRef.

Momosaki R, Abo M, Urashima M. Vitamin D supplementation and post-stroke rehabilitation: a randomized, double-blind, placebo-controlled trial. Nutrients. 2019; 11(6): 1295, CrossRef.

Annweiler C. Vitamin D in dementia prevention. Ann NY Acad Sci. 2016; 1367(1): 57-63, CrossRef.

Palsetia D, Rao GP, Tiwari SC, Lodha P, De Sousa A. The clock drawing test versus mini-mental status examination as a screening tool for dementia: a clinical comparison. Indian J Psychol.Med. 2018; 40(1): 1-10, CrossRef.




DOI: https://doi.org/10.21705/mcbs.v5i1.170

Indexed by:

                     

                    

                    


Cell and BioPharmaceutical Institute