Independent and joint associations of dietary antioxidant intake with risk of post-stroke depression and all-cause mortality

Abstract

Background: Few observational studies have investigated the association of dietary antioxidant intake with post-stroke depression (PSD) risk. We used the cross-sectional and longitudinal design to investigate the independent and joint associations between dietary antioxidant intake and PSD risk and all-cause mortality.

Methods: Participants from the 2005-2014 National Health and Nutrition Examination Survey (NHANES) aged 20 years and older with stroke were included. Logistic and Cox regression analyses were used to assess the associations of dietary antioxidant intake, including vitamin A, vitamin C, vitamin E, zinc, selenium, and carotenoids, and composite dietary antioxidant index (CDAI) with PSD risk and all-cause mortality.

Results: The highest quartile of dietary vitamin A (OR: 0.54, 95%CI: 0.32, 0.92), total carotenoids (OR: 0.56, 95%CI: 0.34, 0.94), and selenium intake (OR: 0.53, 95%CI: 0.31, 0.90) were associated with decreased PSD risk compared with those in the lowest quartile. The results showed a negative association between CDAI and PSD risk, with the lowest OR in the third quartiles (OR: 0.49, 95%CI: 0.30, 0.83). Furthermore, the highest quartile of dietary vitamin A (HR: 0.63, 95%CI: 0.45, 0.89), vitamin E (HR: 0.69, 95%CI: 0.48, 0.99), zinc (HR: 0.57, 95%CI: 0.40, 0.81), selenium (HR: 0.64, 95%CI: 0.46, 0.90), and total carotenoids (HR: 0.66, 95%CI: 0.47, 0.92) intake and CDAI (HR: 0.56, 95%CI: 0.39, 0.81) were associated with decreased all-cause mortality compared with those in the lowest quartile.

Conclusion: Increased intake of dietary antioxidant may protect from depressive symptoms and improve the prognosis of stroke patients.

Keywords: All-cause mortality; Dietary antioxidant; NHANES; Post-stroke depression.