Abstract 161: Prevalence and Course of Depression During the First Year After Stroke

Abstract

Introduction: Depression is prevalent and burdensome in stroke survivors, however, information about its longitudinal course following stroke is limited, especially for the early stage of stroke recovery. The study examined changes in the prevalence and patterns of depression during the first year after stroke. Methods: Data were obtained from the Brain Attack Surveillance in Corpus Christi (BASIC) project (2011-2016), a population-based stroke surveillance study in south Texas. Depressive symptoms at 3, 6 and 12 months post-stroke were assessed using the 8-item Patient Health Questionnaire (range: 0-24); scores≥10 classified as having depression. Cross-tabulations were used to estimate prevalence of depression, and latent transition analysis was used to examine changes in symptom patterns. Results: A total of 684, 574 and 563 participants had complete data at 3, 6 and 12 months, respectively. Mean age was 65.9 (SD=11.2), women and men were evenly distributed, and approximately three-fifths were Mexican American. Prevalence of depression after stroke was 35.2% at 3 months, decreased to 24.4% at 6 months, and remained stable at 25.9% at 12 months. Four latent classes of depressive symptom patterns were identified (Table). There were more transitions from the fatigue and sleep predominant and severe symptom groups to mild and slight/no symptom groups between 3 and 6 months than between 6 and 12 months. The majority of the slight/no symptom group retained this pattern over time; whereas a substantial proportion of the mild symptom group developed more severe symptoms, especially after 6 months. Conclusions: Prevalence of depression peaks at 3 months after stroke, declines thereafter but remains stable and high after 6 months. The course of post-stroke depression is heterogeneous and dynamic. Further research should identify the characteristics of group membership in stroke patients to provide evidence for targeted screening and personalized treatment.