Abstract
BackgroundElderly stroke survivors have been reported to be at risk of malnutrition and depression. Vitamin B-related metabolites such as methylmalonic acid and homocysteine have been implicated in depression.ObjectiveWe conducted a study exploring the relationship between homocysteine and post-stroke depression.DesignThree methodologies were used: Observational cohort study of elderly Swedish patients (n=149) 1.5 years post-stroke, assessed using Diagnostic and Statistical Manual of Mental Disorders, Montgomery Åsberg Depression Rating Scale and serum blood levels of methylmalonic acid and homocysteine.ResultsHomocysteine significantly correlated with depressive symptomatology in stroke survivors (β = 0.18*). Individuals with abnormal levels of methylmalonic acid and homocysteine were almost twice more likely to show depressive symptomatology than those with normal levels (depressive symptoms 22%; no depressive symptoms 12%). Comparison of methylmalonic acid and homocysteine levels with literature data showed fewer stroke survivors had vitamin deficiency than did reference individuals (normal range 66%; elevated 34%).ConclusionsHomocysteine is significantly associated with depressive symptomatology in elderly Swedish stroke survivors.
Highlights
Stroke survivors have been reported to be at risk of malnutrition and depression
The multiple regression showed that peripheral plasma the amino acid homocysteine (tHcy) was significantly associated with Montgomery Asberg Depression Rating Scale (MADRS) depression scores after having controlled for age and gender
The present observational cohort study demonstrates that methylmalonic acid (MMA) and tHcy are associated with a depression diagnosis post-stroke, and that high tHcy expression is a significant predictor of depressive symptoms post-stroke after accounting for age and gender
Summary
Stroke survivors have been reported to be at risk of malnutrition and depression. Vitamin B-related metabolites such as methylmalonic acid and homocysteine have been implicated in depression. Objective: We conducted a study exploring the relationship between homocysteine and post-stroke depression. Design: Three methodologies were used: Observational cohort study of elderly Swedish patients (n 0149) 1.5 years post-stroke, assessed using Diagnostic and Statistical Manual of Mental Disorders, Montgomery Asberg Depression Rating Scale and serum blood levels of methylmalonic acid and homocysteine. Results: Homocysteine significantly correlated with depressive symptomatology in stroke survivors (b 00.18*). Comparison of methylmalonic acid and homocysteine levels with literature data showed fewer stroke survivors had vitamin deficiency than did reference individuals (normal range 66%; elevated 34%). Conclusions: Homocysteine is significantly associated with depressive symptomatology in elderly Swedish stroke survivors
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