Deans' stroke musings: Depression symptoms 6 years after stroke are associated with higher perceived impact of stroke, limitations in ADL and restricted participation

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, May 12, 2022

Depression symptoms 6 years after stroke are associated with higher perceived impact of stroke, limitations in ADL and restricted participation

You wouldn't have to deal with this secondary problem if you solved the primary problem; NO 100% RECOVERY PROTOCOLS FOR ANYTHING IN STROKE!

Depression symptoms 6 years after stroke are associated with higher perceived impact of stroke, limitations in ADL and restricted participation

Scientific Reports volume 12, Article number: 7816 (2022) Cite this article

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Abstract

Late post-stroke depression symptoms are understudied. This study aimed to investigate depression symptoms 6 years after stroke, and associations with perceived impact of stroke, activities of daily living (ADL), and participation in social and everyday activities. Data was collected in a 6-year follow-up in a longitudinal study of stroke. Assessments included Hospital Anxiety and Depression Scale (HADS) for depression symptoms, Stroke Impact Scale 3.0. for perceived impact of stroke, Barthel Index for ADL, Frenchay Activities Index for participation in social and everyday activities. The research questions were addressed by bivariate analyses (with HADS-D ≥ 4 as cut-off), and hierarchical multiple regression analyses using continuous HADS-D scores. Forty percent of the 105 participants (57% men, age 30–91) showed depression symptoms (HADS-D ≥ 4). Depression symptoms were associated with higher perceived impact of stroke, more dependence in ADL, and more restrictions in participation in social and everyday activities. Most of those with depression symptoms had low scores on HADS, indicating that even mild depression symptoms might be relevant to identify and target in treatment and rehabilitation of long-term consequences of stroke.

Introduction

Stroke is a major cause of death and disability worldwide, affecting more than 13 million persons every year¹. Improved acute treatment of stroke in the last decades, with increasing survival rates, calls for efficient strategies for post-stroke rehabilitation. The rehabilitation often occurs in the year following the stroke, with no or few guidelines for longer follow-up. Yet, long-term consequences of stroke are common, which might impact activities of daily living (ADL), and participation in the society^2,3,4. Therefore, long-term consequences of stroke and their interrelationships are relevant to identify, to find targets for treatment and rehabilitation. This study adheres to the International Classification of Functioning, Disability and Health (ICF)⁵, which is based on the biopsychosocial model of disability. In the ICF activity is defined as “the execution of a task or action by an individual” and participation as “involvement in a life situation”.

Depression is more common after stroke⁶ than in the general population⁷ and may contribute to poorer quality of life and functioning^8,9,10. Previous research has reported both early and late onset of post-stroke depression (PSD), with the highest prevalence during the first year^6,8. The aetiology of PSD is still poorly understood but considered to be multifactorial, with biological and psychosocial components contributing to the development of depression symptoms¹⁰.

In recent years, an increased attention has been given to evaluating the efficacy of treatments of PSD¹⁰. Furthermore, different interventions to prevent PSD have been tested, including pharmacological, psychological, and non-invasive brain stimulation treatments, but the current evidence for efficacy of any of these treatments is weak¹¹.

The prevalence of PSD has been reported up to 15 years¹², but there is still a scarcity of research including factors associated with PSD in a longer time perspective. As post-stroke depression has been related to worse functioning¹⁰, relevant areas to investigate include perceived impact of stroke, activities of daily living (ADL) and participation in social and everyday activities.

Therefore, the aims of this study were to investigate depression symptoms 6 years after stroke, and associations with perceived impact of stroke, ADL, and participation in social and everyday activities.