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Low Vitamin D Status and Post-Stroke Depression, Falls, and Functional Recovery in Older Adults with Nonvalvular Atrial Fibrillation-Associated Ischemic Stroke

In brief

Each 10 ng/mL drop in vitamin D raises 3-month disability and fall risk

In 802 older stroke patients with atrial fibrillation, a 10 ng/mL lower serum vitamin D was linked to a 17% higher odds of worse 3-month functional scores and a 29% higher chance of a first fall within a year. Low vitamin D also increased depression odds by about 50%, suggesting it could serve as a simple prognostic marker, pending broader validation.

Journal
Clinical interventions in aging (Q1)
Published
28 July 2026
Study design
Prospective / inception cohort
Evidence level
Level 2, Moderate (CEBM 2b)
Authors
Li Li, Juping Wang, Rongrong Kang, Tianqi Zhang, Zhongsha Chen
PMID
42542873
DOI
10.2147/CIA.S607805

Why clinicians should know about it

Abstract

BACKGROUND: Older adults with atrial fibrillation (AF)-associated acute ischemic stroke are prone to disability, depressive symptoms, and falls; the prognostic value of vitamin D status is uncertain. METHODS: We conducted a single-center prospective cohort study of patients aged ≥65 years with ECG-confirmed AF and imaging-confirmed acute ischemic stroke at a tertiary hospital in China (January 2022-August 2024). Serum 25-hydroxyvitamin D [25(OH)D] within 48 hours was modeled per 10 ng/mL decrement and as <20 vs ≥20 ng/mL. Outcomes were 3-month modified Rankin Scale (mRS) shift, Barthel Index (BI), and PHQ-9 ≥10, plus 12-month time to first fall (death as a competing event) and total falls rate. Models adjusted for prespecified baseline confounders. RESULTS: Among 802 participants, median age was 76.2 years (IQR, 71.6-80.6); 60.7% had 25(OH)D <20 ng/mL. Three-month mRS/BI, 3-month PHQ-9, and falls follow-up data were available for 776 (96.8%), 762 (95.0%), and 742 (92.5%) participants, respectively. Each 10 ng/mL lower 25(OH)D was associated with worse 3-month mRS shift (common OR 1.17, 95% CI 1.05-1.31) and lower BI (β -3.9, 95% CI -6.2 to -1.6). Depressive symptoms occurred in 16.8% and were more common with 25(OH)D <20 ng/mL (OR 1.54, 95% CI 1.07-2.22). Among 742 with falls follow-up, low 25(OH)D predicted first fall (HR 1.29, 95% CI 1.07-1.55) and a higher recurrent falls rate (IRR 1.33, 95% CI 1.10-1.61). CONCLUSION: Lower baseline 25(OH)D was consistently associated with poorer functional recovery, greater depressive symptom burden, and higher fall risk and recurrence, supporting 25(OH)D as a pragmatic prognostic marker; multicenter validation and targeted trials are warranted.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.