Correlation between age-friendly communities and post-stroke depression

While adverse environmental factors are linked to depressive symptoms, the relationship between age-friendly communities (AFC) and post-stroke depression (PSD) remains unclear.

This prospective cohort study enrolled elderly patients with stroke discharged from the neurology department between October 2022 and January 2024. At six months post-discharge, participants were assessed through structured telephone interviews using the AFC framework and the Hamilton Depression Scale (HAMD). Correlation and logistic regression analyses were used to evaluate the associations between AFC domains and PSD.

Among 335 participants (mean age = 73.12 ± 6.8 years; 53.1 % male), 144 were diagnosed with PSD, including mild (n = 52), moderate (n = 30), severe (n = 27), and extreme (n = 35) cases. AFC scores showed a negative correlation with PSD severity (r = -0.63, P < 0.01). Three AFC domains served as protective factors against PSD: housing (OR = 0.76), outdoor spaces and buildings (OR = 0.78), and civic participation and employment (OR = 0.70). An integrated model that combined these AFC domains with post-stroke functional status and social support reached an area under the curve (AUC) of 0.86.

Enhancements in housing, outdoor areas, and civic engagement could reduce the PSD burden and promote the integration of AFC principles into stroke recovery strategies.