A linkage among 25 (OH) D and post-stroke cognitive impairment and the prognosis of stroke
Authors: Xiong Jianrong , Li Yongxiang , Li Jinhui , Zhao Chenliang 
Published: September 2023

Abstract
Objective: A series of complications can occur after stroke. Post-stroke cognitive impairment (PSCI) is a frequent complication that occurs after a stroke. However, the connection aomng 25-hydroxyvitamin D (25 (OH) D), cognitive impairment, and outcomes among individuals who are with stroke is not yet fully understood. The objective of the research aimed to explore the link between 25 (OH) D, cognitive dysfunction, and prognosis following a stroke.
Methods: The concentrations of serum 25-hydroxyvitamin D were assessed within the initial 24 hours when the participants was admitted to hospital. Cognitive impairment in participants who suffered from stroke was assessed utilizing the scale called Mini-Mental State Examination (MMSE). Functional independence of patients was evaluated using the Barthel Index (BI) on the day the patient was discharged. Additionally, the duration of hospitalization for each patient was calculated.
Results: The study involved a cohort of 131 participants, among whom cognitive impairment was identified in 70 patients. The average age of the participants was 56.92 (±12.9) years. Among all the participants, 39 were female. Among all the participants, the majority had insufficient serum 25-hydroxyvitamin D levels. Specifically, 26 individuals displayed serum 25-hydroxyvitamin D severe deficiency, with a concentration of 25 (OH) D <25 nmol/L, 72 patients exhibited deficiency, with a concentrations ranging between 25-50 nmol/L. as well as 31 patients showcased insufficiency, with a serum concentrations50-75 nmol/L and 2 participants suffered from sufficiency, with a serum concentrations ≥75 nmol/L. An observation revealed that the levels of 25 (OH) D were comparatively reduced in stroke people who suffered from cognitive impairment as opposed to individuals without such impairment (p=0.022). Patients who experienced cognitive impairment following a stroke exhibited diminished Barthel Index (BI) scores (p<0.001) and extended durations of hospitalization (p=0.002) in contrast to patients devoid of cognitive impairment. When comparing groups with different concentrations of 25 (OH) D, a phenomenon was caught that individuals with low concentrations had longer hospitalization duration (p=0.03) and higher NIHSS scores (p=0.003) compared to those with high concentrations of 25 (OH) D. Nonetheless, there existed no substantial disparity in Barthel Index (BI) scores within the patient cohorts distinguished by varying concentrations of 25-hydroxyvitamin D.
Conclusions: The investigation indicated a potential linkage between reduced concentrations of 25-hydroxyvitamin D and an escalated susceptibility to cognitive impairment subsequent to a stroke. Furthermore, a phenomenon came to light that participants suffered from lower concentrations of 25 (OH) D tend to have longer hospital stays compared to those with higher concentrations. However, this research did not establish a direct linkage between diminished levels of 25 (OH) D and unfavorable prognosis in individuals affected by stroke.