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
. 2025 Jun;10(2):610-617.
doi: 10.1177/23969873241284725. Epub 2024 Sep 26.

Depressive symptoms profile and dementia risk after spontaneous intracerebral haemorrhage

Giuseppe Scopelliti  1   2 , Maéva Kyheng  3 , Barbara Casolla  4 , Grégory Kuchcinski  5 , Grégoire Boulouis  6 , Solène Moulin  7 , Julien Labreuche  3 , Hilde Hénon  1 , Marco Pasi  8 , Charlotte Cordonnier  1
Affiliations

Depressive symptoms profile and dementia risk after spontaneous intracerebral haemorrhage

Giuseppe Scopelliti et al. Eur Stroke J. 2025 Jun.

Abstract

Introduction: Depressive symptoms are commonly reported after spontaneous intracerebral haemorrhage (ICH) and frequently associated with cognitive decline. Using hierarchical clustering analysis (HCA), we aimed to identify different post-ICH depressive symptoms profiles and to evaluate their association with dementia risk.

Methods: We included consecutive patients from the prospective Prognosis of Intracerebral Haemorrhage (PITCH) study who survived 6 months after the ICH. We performed HCA using depressive symptoms severity (assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS)), along with the presence of apathy and anxiety (screened using Neuropsychiatric Inventory questionnaire). Baseline clinical/neuroimaging characteristics and risk of incident dementia were compared between different profiles using univariate and multivariable models.

Results: Of 265 six-month ICH survivors, 221 (83%) underwent neuropsychiatric screening (mean age 65.5 years; 57% male). Using HCA, 3 profiles were identified: (1) without significant depressive symptoms (n = 152; median MADRS score = 2 [IQR 0-4]); (2) depressive symptoms with predominant apathy (n = 41; median MADRS score = 15 [IQR 5-20], 68% with apathy); (3) depressive symptoms profile with predominant anxiety (n = 28; median MADRS score = 17 [IQR 9-25]; 100% with anxiety). Compared to patients without depressive symptoms, patients with depressive symptoms and predominant apathy (but not those with predominant anxiety) were more likely to have cerebral atrophy (OR = 2.4, 95% CI = 1.4-4.2) and had significantly higher long-term new-onset dementia risk (adjusted hazard ratio = 2.2, 95% CI = 1.3-3.8).

Conclusion: Screening for apathy and anxiety on top of depressive symptoms might help identifying patients at risk for dementia. Future studies on treatment should account for different post-ICH depressive symptoms profiles that may impact on cognitive function.

Keywords: ICH; Intracerebral haemorrhage; anxiety; apathy; cerebral small vessel disease; dementia; depression; post-stroke dementia.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Graphical abstract
Graphical abstract
Figure 1.
Figure 1.
Flowchart of patient inclusion. ICH: intracerebral haemorrhage.
Figure 2.
Figure 2.
Long-term risk of dementia according to depressive symptoms profile. Profile 1: no significant depressive symptoms (ND); profile 2: depressive symptoms with predominant apathy (DAp); profile 3: depressive symptoms with predominant anxiety (DAx).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Kim KT, Chang WK, Jung YS, et al. Unmet needs for rehabilitative management in common health-related problems negatively impact the quality of life of community-dwelling stroke survivors. Front Neurol 2021; 12: 2440. - PMC - PubMed
    1. Hill G, Regan S, Francis R. Research priorities to improve stroke outcomes. Lancet Neurol 2022; 21: 312–313. - PMC - PubMed
    1. Towfighi A, Ovbiagele B, El Husseini N, et al. Poststroke depression: a scientific statement for healthcare professionals from the American heart association/American stroke association. Stroke 2017; 48: e30–e43. - PubMed
    1. Roth DL, Haley WE, Sheehan OC, et al. Depressive symptoms after ischemic stroke: population-based comparisons of patients and caregivers with matched controls. Stroke 2020; 51: 54–60. - PMC - PubMed
    1. Wu Y, Wang L, Hu K, et al. Mechanisms and therapeutic targets of depression after intracerebral hemorrhage. Front Psychiatry 2018; 9: 682. - PMC - PubMed

LinkOut - more resources