Association between hyperhomocysteinemia and frailty in older adults with acute ischemic stroke: A cross-sectional study.

PURPOSE: Frailty is common among patients with acute ischemic stroke (AIS) and is associated with adverse health outcomes. Although hyperhomocysteinemia (Hhcy) is a recognized biomarker in AIS, its association with frailty remains unclear. This study aimed to examine the relationship between Hhcy and frailty and assess whether Hhcy is independently associated with frailty in AIS patients. PATIENTS AND METHODS: We conducted a cross-sectional study involving 397 AIS patients admitted between April 2023 and April 2024. Frailty was assessed using the Tilburg Frailty Indicator (TFI). Clinical and laboratory data, including homocysteine levels, were collected at admission. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for variable selection, followed by multivariable logistic regression to examine the independent association between Hhcy and frailty in AIS. RESULTS: Of the 397 AIS patients, 154 (38.8%) were identified as frail. Hhcy was significantly associated with frailty across all adjusted models (adjusted odds ratios: 1.660-1.859, all p < 0.05), independent of sociodemographic characteristics, medical history, clinical parameters, and health indicators. Other significant factors associated with frailty included age ≥75 years, being unmarried, vitamin B12 levels, NIHSS score, and PHQ-9 score. CONCLUSION: Hhcy is independently associated with frailty in AIS patients. This finding suggests that homocysteine may serve as a potential biomarker for early frailty risk stratification in this population.