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Post-Stroke Depression and Cognitive Aging: A Multicenter, Prospective Cohort Study.

Minyoung Shin1,2, Min Kyun Sohn3, Jongmin Lee4

  • 1Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.

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|March 25, 2022
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Summary

Post-stroke depression significantly increases cognitive decline risk in older stroke patients, particularly males. Negative thinking exacerbates this risk in older men, while women may also face cognitive decline risks.

Keywords:
cognitive declinedementiaolder adultspost-stroke depressionstroke

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Area of Science:

  • Neurology
  • Gerontology
  • Psychiatry

Background:

  • Post-stroke depression (PSD) is a common complication following stroke.
  • Cognitive aging is a concern for elderly stroke survivors.
  • The interplay between PSD and cognitive decline in stroke patients requires further investigation.

Purpose of the Study:

  • To investigate the impact of post-stroke depression (PSD) on cognitive aging in elderly stroke patients.
  • To identify risk factors for cognitive decline in stroke survivors.
  • To explore potential sex differences in the relationship between PSD and cognitive aging.

Main Methods:

  • Interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation (n=3215).
  • Inclusion criteria: first-ever stroke, normal cognitive function at 3 months post-stroke.
  • PSD assessed using Korean Geriatric Depression Scale Short Form (K-GDS-SF); cognitive aging defined by decline in Korean version of Mini-Mental Status Examination (K-MMSE).

Main Results:

  • PSD significantly increased the hazard ratio (HR) for cognitive decline in older patients (≥65 years) (HR=2.16).
  • The association between PSD and cognitive decline was more pronounced in older males (HR=2.50) compared to older females (HR=1.80).
  • Negative judgment about past, present, and future was a significant factor contributing to cognitive decline in older male patients.

Conclusions:

  • Early post-stroke depression is a significant risk factor for cognitive decline in elderly stroke patients, especially males.
  • Negative thinking patterns in older male stroke survivors are linked to increased cognitive decline risk.
  • Cognitive decline risk in older women post-stroke warrants attention, suggesting sex-specific preventive strategies are needed.