TY - JOUR
T1 - Explanatory factors for the association between depression and long-term physical disability after stroke
AU - Ayerbe Garcia-Morzon, Luis
AU - Ayis, Salma Ahmed Mohamed
AU - Crichton, Siobhan
AU - Rudd, Anthony
AU - Wolfe, Charles David Alexander
PY - 2015/10/6
Y1 - 2015/10/6
N2 - Objectives: to identify explanatory factors for the association between depression at 3 months after stroke and physical disability at 3 years.
Methods: data from the South London Stroke Register (1998–2013) were used. Patients (n = 3,612) were assessed at stroke onset. Follow-up at 3 months included assessment for depression with the Hospital Anxiety and Depression scale (scores ≥ 7 = depression), physical disability (Barthel index) cognitive function, smoking habit, selective serotonin reuptake inhibitors (SSRIs) use, perception of recovery and social support. Physical disability was reassessed at 3 years. The associations between depression at 3 months and physical disability at 3 years were estimated with multinomial regression adjusting for age, gender, ethnicity, stroke severity and possible explanatory factors for the association (introduced in the models first individually and then sequentially): pre-stroke medical history and physical disability, cognitive function, smoking, SSRIs, perception of recovery and social support at 3 months.
Results: one thousand three hundred and seven survivors were assessed at 3 months, of which 418 (32.0%) had depression. Survivors with depression had a higher physical disability rate at 3 years. These associations remained significant after adjustment for individual explanatory factors but were not significant after adjustment for combined explanatory factors. Physical disability at 3 months was a relevant explanatory factor for this association. SSRIs were associated with severe, relative risk: 6.62 (2.92–15.02) P < 0.001, and moderate physical disability, relative risk: 3.45 (1.58–7.52) P = 0.002, at 3 years.
Conclusion: the association between depression and physical disability appears to be multifactorial. The use of SSRIs after stroke requires further research.
AB - Objectives: to identify explanatory factors for the association between depression at 3 months after stroke and physical disability at 3 years.
Methods: data from the South London Stroke Register (1998–2013) were used. Patients (n = 3,612) were assessed at stroke onset. Follow-up at 3 months included assessment for depression with the Hospital Anxiety and Depression scale (scores ≥ 7 = depression), physical disability (Barthel index) cognitive function, smoking habit, selective serotonin reuptake inhibitors (SSRIs) use, perception of recovery and social support. Physical disability was reassessed at 3 years. The associations between depression at 3 months and physical disability at 3 years were estimated with multinomial regression adjusting for age, gender, ethnicity, stroke severity and possible explanatory factors for the association (introduced in the models first individually and then sequentially): pre-stroke medical history and physical disability, cognitive function, smoking, SSRIs, perception of recovery and social support at 3 months.
Results: one thousand three hundred and seven survivors were assessed at 3 months, of which 418 (32.0%) had depression. Survivors with depression had a higher physical disability rate at 3 years. These associations remained significant after adjustment for individual explanatory factors but were not significant after adjustment for combined explanatory factors. Physical disability at 3 months was a relevant explanatory factor for this association. SSRIs were associated with severe, relative risk: 6.62 (2.92–15.02) P < 0.001, and moderate physical disability, relative risk: 3.45 (1.58–7.52) P = 0.002, at 3 years.
Conclusion: the association between depression and physical disability appears to be multifactorial. The use of SSRIs after stroke requires further research.
UR - http://www.scopus.com/inward/record.url?scp=84947789370&partnerID=8YFLogxK
U2 - 10.1093/ageing/afv132
DO - 10.1093/ageing/afv132
M3 - Article
VL - 44
SP - 1054
EP - 1058
JO - Age & Ageing
JF - Age & Ageing
IS - 6
ER -