No benefit.
B-vitamin supplementation on mitigating post-stroke cognition and neuropsychiatric sequalae: A randomized controlled trial.
Abstract
Background and Purpose
A third of stroke patients suffer from post-stroke cognitive decline, depressive, and anxiety symptoms. B-vitamin supplementation provides a possible safe and affordable treatment to mitigate post-stroke neuropsychiatric sequelae via reducing homocysteine levels. Our study aims to examine the effect of B-vitamin supplementation in the prevention of post-stroke cognitive decline, depressive, and anxiety symptoms. Our secondary aims were to investigate associations between baseline factors and the three outcomes.
Methods
Patients were recruited as part of a Singaporean sub-study of a randomized controlled trial that examined the effect of B-vitamin supplementation on recurrent cardiovascular events. Cognitive decline, depressive and anxiety symptoms were assessed with neuropsychological assessments and Hospital Anxiety and Depression Scale 6 monthly. Cox regression analyses was performed to determine treatment efficacy. Logistic regression used to examine factors associated with cognitive decline, depressive and anxiety symptoms.
Results
A total of 707 were included in the analyses. Survival and hazards ratio analysis showed no treatment effect of B-vitamins on cognitive decline, depressive and anxiety symptoms. Cognitive decline was only associated with age. Depressive symptoms were associated with large anterior cerebral infarcts and hyperlipidaemia
Conclusions
Our study showed no benefit of supplementation with B-vitamins for post-stroke cognitive decline, depressive or anxiety symptoms. Depressive symptoms was associated with larger anterior cerebral infarcts, which may be reflective of the disability associated with larger infarcts.
Registration-URL: http://www.clinicaltrials.gov; Unique identifier: NCT00097669
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