PTOTSLPCohortJournal of rehabilitation medicine2021

Predictors for self-reported feeling of depression three months after stroke: A longitudinal cohort study.

Janina Kaarre, Tamar Abzhandadze, Katharina S Sunnerhagen

PMID 33739435

WHAT IT FOUND

Cognitive screening 36–48 hours after stroke did not predict depression three months later.

Female sex, being younger than 70, and living alone before the stroke were significant predictors. Use these social and demographic factors, not early cognitive scores, to identify patients at risk for post-stroke depression.

Key findings

01Cognitive function assessed with the MoCA within 36–48 hours of admission was not a significant predictor of self-reported feeling of depression at 3 months.

02Female patients had significantly higher odds of reporting depression at 3 months compared to male patients.

03Patients aged 70 years or older had decreased odds of depression, and those living alone before the stroke had higher odds.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The study excluded patients with severe cognitive impairment or high dependency in ADL at baseline, meaning the results do not apply to the most severely affected stroke patients. Depression was assessed via a single self-reported question ('do you feel depressed?') rather than a clinical diagnostic interview. Cognitive screening occurred only 36–48 hours post-admission, a time when acute effects like delirium or fatigue may confound results. 17% of the initial cohort was lost to follow-up at 3 months.

Declared interests

The study used data from the Gothenburg Very Early Supported Discharge study (GOTVED) and the Swedish national quality register for stroke care (Riksstroke). The text does not specify direct funding sources or author conflicts of interest for this specific analysis.

The easy way to misread this

Do not assume that patients with normal cognitive scores on the MoCA in the first two days after stroke are at low risk for depression. The study found no predictive value in early cognitive scores; risk was driven by social and demographic factors like living alone, sex, and age.

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