Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep 12;14(1):21352.
doi: 10.1038/s41598-024-72742-z.

Increased risk of depression and associated symptoms in poststroke aphasia

Shih-Kai Kao  1 , Chia-Ta Chan  2   3   4
Affiliations

Increased risk of depression and associated symptoms in poststroke aphasia

Shih-Kai Kao et al. Sci Rep. .

Abstract

Poststroke aphasia hinders patients' emotional processing and social adaptation. This study estimated the risks of depression and related symptoms in patients developing or not developing aphasia after various types of stroke. Using data from the US Collaborative Network within the TriNetX Diamond Network, we conducted a retrospective cohort study of adults experiencing their first stroke between 2013 and 2022. Diagnoses were confirmed using corresponding International Classification of Diseases, Tenth Revision, Clinical Modification codes. Patients were stratified by poststroke aphasia status and stroke type, with propensity score matching performed to control for confounders. The primary outcome was depression within one year post-stroke; secondary outcomes included anxiety, fatigue, agitation, emotional impact, and insomnia. Each matched group comprised 12,333 patients. The risk of depression was significantly higher in patients with poststroke aphasia (hazard ratio: 1.728; 95% CI 1.464-2.038; p < 0.001), especially those with post-hemorrhagic-stroke aphasia (hazard ratio: 2.321; 95% CI 1.814-2.970; p < 0.001). Patients with poststroke aphasia also had higher risks of fatigue, agitation, and emotional impact. Anxiety and insomnia risks were higher in those with post-hemorrhagic-stroke aphasia. Poststroke aphasia, particularly post-hemorrhagic-stroke aphasia, may increase the risks of depression and associated symptoms, indicating the need for comprehensive psychiatric assessments.

Keywords: Anxiety; Aphasia; Depression; Hemorrhagic stroke; Stroke.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A flow chart showing the selection of patients.
Fig. 2
Fig. 2
The Kaplan–Meier curves depicting depression in post-stroke patients with aphasia compared to those without aphasia after propensity score matching across different stroke types. Upper total stroke patients, Middle: ischemic stroke patients, Lower: hemorrhagic stroke patients.
Fig. 3
Fig. 3
The Kaplan–Meier curves depicting depression in post-ischemic-stroke aphasia compared to post-hemorrhagic-stroke aphasia.
Fig. 4
Fig. 4
Analysis of depression, anxiety, and other depression-related symptoms in post-stroke aphasia after propensity score matching stratified by ischemic stroke (N = 9,456) and hemorrhagic stroke (N = 3,158). HR Hazard ratio, CI Confidence interval.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Mozaffarian, D. et al. Heart disease and stroke statistics–2015 update: A report from the American Heart Association. Circulation131, e29-322. 10.1161/cir.0000000000000152 (2015). 10.1161/cir.0000000000000152 - DOI - PubMed
    1. Zhou, H., Wei, Y. J. & Xie, G. Y. Research progress on post-stroke depression. Exp. Neurol.373, 114660. 10.1016/j.expneurol.2023.114660 (2024). 10.1016/j.expneurol.2023.114660 - DOI - PubMed
    1. Shi, Y., Yang, D., Zeng, Y. & Wu, W. Risk factors for post-stroke depression: A meta-analysis. Front. Aging Neurosci.9, 218. 10.3389/fnagi.2017.00218 (2017). 10.3389/fnagi.2017.00218 - DOI - PMC - PubMed
    1. Taylor-Rowan, M. et al. Prevalence of pre-stroke depression and its association with post-stroke depression: A systematic review and meta-analysis. Psychol. Med.49, 685–696. 10.1017/s0033291718002003 (2019). 10.1017/s0033291718002003 - DOI - PubMed
    1. Mitchell, A. J. et al. Prevalence and predictors of post-stroke mood disorders: A meta-analysis and meta-regression of depression, anxiety and adjustment disorder. Gen. Hosp. Psychiatry47, 48–60. 10.1016/j.genhosppsych.2017.04.001 (2017). 10.1016/j.genhosppsych.2017.04.001 - DOI - PubMed

LinkOut - more resources