Deans' stroke musings: Neuropsychiatric complications 3-4 years after stroke: a population-based study of fatigue, depression and cognition

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.

Friday, July 11, 2025

Neuropsychiatric complications 3-4 years after stroke: a population-based study of fatigue, depression and cognition

If your doctor has to treat this it means complete failure of 100% recovery! You're fired!

Neuropsychiatric complications 3-4 years after stroke: a population-based study of fatigue, depression and cognition

J Aked 1 2, Hossein Delavaran 3 4, Fredrik Wennerström 5, Arne Lindgren 3 6

Affiliations

PMID: 40623741
PMCID: PMC12230960
DOI: 10.1136/bmjopen-2024-096908

Abstract

Objectives: To study the prevalence of and interplay between common neuropsychiatric sequelae 3-4 years after onset of first-ever stroke-specifically post-stroke fatigue (PSF), post-stroke depression (PSD) and post-stroke cognitive impairment (PSCI).

Design: Population-based cohort study.

Setting: Catchment area of a Swedish University Hospital.

Participants: We recruited individuals with first-ever ischaemic stroke or intracerebral haemorrhage in the initial cohort; 151 of these died prior to follow-up and 47 (12%) were lost to detailed follow-up. We followed up 202 individuals with median age: 72 (IQR 65-79), 40% female, either in clinic, via home visits or via telephone.

Primary and secondary outcome measures: Primary outcome measures included PSF (Fatigue Assessment Scale), PSD (Patient Health Questionnaire-9) and PSCI (Montreal Cognitive Assessment). Secondary outcome measures included dependency in activities of daily living (ADL; Barthel Index), health-related quality of life (HRQoL; Short-Form Questionnaire-36, EuroQoL-5D and Stroke Impact Scale) and stroke severity (National Institutes of Health Stroke Scale (NIHSS)).

Results: Significant PSF was present in 46/195 (24%), PSD in 21/191 (11%), and PSCI in 93/173 (54%) respondents. Among 169 participants with available data for all three domains, 100 (59%) had impairment in at least one domain. Participants with PSCI were older than those without (median: 75 vs 67 years; p<0.01), but age did not differ for those with/without PSF or PSD. Among 21 respondents with PSD, 20 (95%) had PSF. PSD and PSF were strongly correlated (ϱ=0.69; p<0.01) and PSF was associated with worse HRQoL (HR: 1.15; 95% CI 1.08 to 1.22; p<0.001). ADL dependency was associated with worse NIHSS at follow-up (B: -3.81; 95% CI -4.77 to -2.85), baseline home care (B: -18.34; 95% CI -26.95 to -9.73) and PSF (B: -0.65; 95% CI -1.05 to -0.26).

Conclusions: PSF, PSD and PSCI are highly prevalent 3-4 years after stroke. PSF and PSD overlap and correlate. PSF is associated with ADL dependency and worse HRQoL. Clinical awareness and research of treatment for neuropsychiatric complications of stroke are needed.

(WOW! Going down the wrong route; you prevent these secondary problems by solving the primary problem of 100% recovery. You're that blitheringly stupid you don't belong in stroke!)

Keywords: Cognition; Depression & mood disorders; Fatigue; Stroke.