Association of depression and anxiety with cognitive impairment 6 months after stroke

Journal article

OBJECTIVE: Investigate the associations between general cognitive impairment and domain specific cognitive impairment with post-stroke depression and anxiety at six-months post-stroke.

METHODS: Participants were confirmed acute stroke patients from the OCS-CARE study who were recruited on stroke wards in a multi-site study and followed up at a 6 months post-stroke assessment. Depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale sub-scales, with scores greater than seven indicating possible mood disorders. General cognitive impairment at follow-up was assessed using the Montreal Cognitive Assessment, stroke-specific cognitive domain impairments was assessed using the Oxford Cognitive Screen. Linear regression was used to examine the associations between cognition and depression/anxiety symptoms at 6-months, controlling for acute-stroke severity and ADL-impairment, age, sex, education, and co-occurring post-stroke depression/anxiety.

RESULTS: 437 participants mean age=69.28 years (S.D.=12.17), 226 male (51.72%), were included in analyses. Six-month post-stroke depression (n=115, 26%) was associated with six-month impairment on the MoCA (beta [b] =0.96, standard error [SE] =0.31, p=0.006), and all individual domains assessed by the OCS: spatial attention (b=0.67, SE=0.33, p =0.041), executive function (b=1.37, SE=0.47, p=0.004), language processing (b=0.87, SE=0.38, p=0.028), memory (b=0.76, SE=0.37, p=0.040), number processing (b=1.13, SE=0.40, p=0.005), praxis (b=1.16, SE =0.49, p=0.028). Post-stroke anxiety (n=133, 30%) was associated with impairment on the MoCA (b=1.47, SE=0.42, p=0.001), and spatial attention (b=1.25, SE=0.45, p=0.006), these associations did not remain significant after controlling for co-occurring post-stroke depression.

CONCLUSION: Domain-general and domain-specific post-stroke cognitive impairment was found to be highly related to depressive symptomatology but not anxiety symptomatology.

Authors: Williams, OA; Demeyere, N

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: American Academy of Neurology
• Journal: Neurology
• Volume: 96
• Issue: 15
• Pages: e1966-e1974
• Publication date: 2021-02-25
• Acceptance date: 2021-01-13
• DOI: 10.1212/WNL.0000000000011748
• EISSN: 1526-632X
• ISSN: 0028-3878
• Language: English
• Keywords: FFR