The Association Between Post-stroke Depression, Aphasia, and Physical Independence in Stroke Patients at 3-Month Follow-Up

Abstract

Objective: Few studies have examined the association between post-stroke depression (PSD), aphasia, and physical independence in Chinese patients. This study investigated the above association in stroke patients in China at 3-month follow-up.Methods: Altogether 270 patients within 14 days after ischemic stroke were recruited and followed up at 3 months. PSD, aphasia, and physical functional status were measured using the Stroke Aphasia Depression Questionnaire (SADQ), Western Aphasia Battery (WAB), and modified Rankin Scale (mRS), respectively. Patients with mRS total score >2 were considered as having “physical dependence.”Results: Out of 248 patients at 3-month follow up, 119 (48%) were rated as having physical dependence. Multiple logistic regression analyses revealed that female (p = 0.04; OR = 2.2; 95% CI: 1.0–5.1), more severe stroke at admission (p < 0.01; OR = 1.4; 95% CI: 1.3–1.5), and more severe PSD at 3 months (p = 0.01; OR = 1.05; 95% CI: 1.01–1.1) were independently associated with physical dependence at 3 months.Conclusions: Greater PSD and stroke severity were independently associated with physical dependence at 3 months after stroke. Aphasia was also associated with physical dependence but the relationship was not significant. Early and effective depression screening, treatment and stroke rehabilitation appear to be important to improve the physical outcome and reduce the burden of stroke survivors.

Effectiveness of Early Rehabilitation Combined With Virtual Reality Training on Muscle Strength, Mood State, and Functional Status in Patients With Acute Stroke: A Randomized Controlled Trial

“…The psychological health of patients with stroke is associated with the patients’ level of disability and dependence (Menon et al, 2017; Wang et al, 2018). In the current study, most patients with stroke were identified within 4 hr following admission as having depression (84.8%) and anxiety (86.9%).…”

“…Such psychological states may lead to reduced motivation and low adherence to rehabilitation training and increased burden of caregivers. Both the depression and anxiety of patients with stroke and the caregiver’s burdens are associated with the patients’ level of disability and dependence (Menon et al, 2017; Wang et al, 2018). It could be conjectured that increasing muscle strength and functional status for patients with stroke early in their rehabilitation may lead to improved psychological health and reduced caregiver burden.…”

Depressed Mood after Stroke: Predictive Factors at Six Months Follow-Up

“…PSD tends to have more severe depressive symptoms than MD does [ 18 ]. Main symptoms of PSD are depressive mood, more cognitive impairment, apathy, less anhedonia, inappetence, less sleep disturbance, decreased energy, self-blame, self-mutilation and even suicidal tendencies [ 4 , 18 , 19 , 20 ]. Individuals with PSD have a disproportionally high prevalence of physical disability such as aphasia, motor/gait impairment and sensory losses [ 13 ].…”

The changed functional status of the brain was involved in patients with poststroke aphasia: Coordinate‐based (activation likelihood estimation) meta‐analysis

“…

Language impairment is one of the clinical manifestations of stroke.The estimated prevalence of poststroke aphasia (PSA) ranges from 21% to 38% (Berthier, 2005). Patients with PSA suffer not only isolated social emotions (Kauhanen et al, 2000), depression (Bullier et al, 2020), and low quality of life (Wang et al, 2018) but also speech impairment.Speech impairment may be improved by using cortical stimulation or pharmacotherapy. However, half of PSA patients recover much or all

…”

“…The estimated prevalence of poststroke aphasia (PSA) ranges from 21% to 38% (Berthier, 2005). Patients with PSA suffer not only isolated social emotions (Kauhanen et al, 2000), depression (Bullier et al, 2020), and low quality of life (Wang et al, 2018) but also speech impairment.…”