title: Albumin and depression in elderly stroke survivors: An observational cohort study.
abstract: OBJECTIVE
  Post-stroke depression affects approximately one third of stroke survivors. In non-stroke affected populations, depressive symptomatology is associated with hypoalbuminemia. This is also common among stroke survivors and associated with poor outcome and increased mortality. The role of stroke-associated hypoalbuminemia in post-stroke depression is not clear. We aimed to explore the relationship between serum albumin and post-stroke depression, as measured 20 months post-stroke.
  
  
  METHODS
  Observational cohort study of elderly Swedish patients drawn from the 'Gothenburg 70+ Stroke Study' (n=149) and assessed at 20 months after stroke onset. Serum albumin was drawn from venous blood and analysed with gas chromatography/mass spectrometry. Depressive symptomatology was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) and functional impairment was assessed using the Barthel Index.
  
  
  RESULTS
  Analysis of covariance analysis showed that serum albumin levels were associated with depressive symptoms at 20 months after stroke. Multivariate analysis of covariance showed that disability scores at 3 days were associated with depressive symptoms at 20 months after stroke and after accounting for the age covariate. Stroke survivors were not clinically deficient in serum albumin.
  
  
  CONCLUSIONS
  Low serum albumin appears to be associated with depressive symptoms in elderly individuals long term post-stroke.
authors.affiliation: Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 100, S-405 30 Gothenburg, Sweden. Electronic address: Michaela.pascoe@gmail.com.
authors.forename: Michaela C
authors.initials: MC
authors.lastname: Pascoe
authors.affiliation: Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 100, S-405 30 Gothenburg, Sweden. Electronic address: ingmar.skoog@gu.se.
authors.forename: Ingmar
authors.initials: I
authors.lastname: Skoog
authors.affiliation: Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 100, S-405 30 Gothenburg, Sweden. Electronic address: christian.blomstrand@gu.se.
authors.forename: Christian
authors.initials: C
authors.lastname: Blomstrand
authors.affiliation: Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 100, S-405 30 Gothenburg, Sweden; Florey Institute of Neuroscience and Mental Health, Melbourne-245 Burgundy Street, Heidelberg, Victoria 3084, Australia; Hunter Medical Research Institute, Newcastle-1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia. Electronic address: Thomas.Linden@neuro.gu.se.
authors.forename: Thomas
authors.initials: T
authors.lastname: Linden
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000032:analysis*; D015331:Cohort Studies; D003863:Depression / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D020521:Stroke / Q000097:blood* / Q000523:psychology; D017741:Survivors / Q000523:psychology*; D013548:Sweden
chemical_list: D000418:Albumins
keywords: Depression; Old age; Outcome; Risk factors; Stroke