Depression after minor stroke: Prevalence and predictors

Severity of stroke and disability after stroke are major predictors of post-stroke depression (PSD). The prevalence of PSD in patients with minor stroke is expected to be low because minor stroke is characterized by mild neurological dysfunction. The aim of this study was to investigate the prevalence and predictors of PSD in patients with minor ischemic stroke.

Patients with first-ever minor ischemic stroke (n=757) were followed up at 14±2 days, 3 months, 6 months, and 1year after stroke. Depression status was assessed at each follow-up. Patients that had PSD at follow-ups were classified into two groups according to the time point of the diagnosis of PSD: patients diagnosed at 14±2 days formed the early-onset PSD group, and those who were diagnosed at any subsequent follow-ups constituted the late-onset PSD group.

The 1-year prevalence of PSD in patients with minor stroke was 29.0% (95% CI, 25.2-32.8). Female gender, current smoking at stroke onset, mild global cognitive impairment at 14±2 days, and stroke recurrence were independently associated with a high risk of PSD over the 1-year follow-up. Predictors of early-onset PSD included female gender, current smoking, and mild global cognitive impairment at 14±2 days, while predictors of late-onset PSD were current smoking and stroke recurrence.

Approximately three in ten patients with first-ever minor ischemic stroke may develop depression during the first year after stroke. Female gender, smoking, mild global cognitive impairment, and stroke recurrence predict early-onset or late-onset PSD after minor ischemic stroke.