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ASSOCIATION BETWEEN POST-STROKE DEPRESSION AND FUNCTIONAL RECOVERY AFTER STROKE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Background and Aims
Depression is associated with an increased risk of stroke and mortality. However, effects of post-stroke depression (PSD) on functional outcomes after stroke are unclear. This meta-analysis aims to determine the association between PSD and functional recovery after stroke.
A systematic search of articles using Medline, Embase and Scopus databases was performed from date of inception to 13th May 2021. All non-randomised cohort studies investigating ischaemic and haemorrhagic stroke patients with PSD were included. Another inclusion criterion was the use of a validated functional scale, such as the modified Rankin scale (mRS) and Barthel Index (BI), to measure functional recovery. Studies were excluded if participants had pre-existing depression at baseline and where functional outcomes were measured before 90 days following stroke. Data were extracted and analysed using a random-effects model, with calculated pooled odds ratios (OR) and 95% confidence intervals (CI).
Ten prospective cohort studies involving 2,858 patients suffering from stroke were included. 1,173 patients were diagnosed with post-stroke depression, and 1,685 did not have depression. The pooled OR for functional impairment at 3 months of follow-up in patients with post-stroke depression was 3.45 (95% CI: 2.01, 5.91, p<0.00001, I2=81%). There was no association between the type of stroke and the incidence of post-stroke depression, nor was there an impact of stroke subtype on functional recovery.
This meta-analysis suggests that PSD may be an independent predictor of functional outcomes among stroke patients. Further studies are required to investigate whether treatment of PSD would aid functional recovery in the rehabilitation of stroke patients.