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April 22, 2026

Gender Differences in the Prevalence and Correlates of Post‐Stroke Depression Among Older Stroke Survivors: Findings From a National Survey in China

Key Points

This study aims to explore gender differences in the prevalence and correlates of post-stroke depression among older stroke survivors.
Analyzed data from a national survey in China conducted from 2017 to 2018.
Used the Center for Epidemiologic Studies Depression Scale to measure depressive symptoms.
Performed univariate and multivariate analyses to identify correlates of post-stroke depression by gender.
Overall post-stroke depression prevalence was 34.28%, with higher rates in females (38.71%) compared to males (30.10%).
In males, physical exercise reduced PSD risk, while activity limitations and severe anxiety increased it.
In females, physical exercise was also linked to lower PSD risk, while heart disease and severe anxiety heightened the risk.

Abstract

ABSTRACT Background Post‐stroke depression (PSD) is a common neuropsychiatric complication in stroke survivors. However, gender differences in the prevalence and correlates of PSD are underexplored. This study examined gender differences in PSD prevalence and their demographic and clinical correlates among older stroke survivors. Methods Data from a large national survey conducted in China during 2017–2018 were analyzed. Depressive symptoms were measured using the 10‐item Center for Epidemiologic Studies Depression Scale. Univariate and multivariate analyses examined the demographic and clinical correlates of PSD by gender. Results A total of 1123 older stroke survivors (65 years of age or above), including 578 males (51.5%) and 545 females (48.5%), were included. The overall PSD prevalence was 34.28% (95% CI = 31.52%–37.15%), with significantly higher prevalence in females (38.71%; 95% CI: 34.62%–42.96%) compared to males (30.10%; 95% CI: 26.42%–34.05%). In males, engaging in recent physical exercise (OR: 0.604; 95% CI: 0.389–0.936; p = 0.024) was associated with a lower PSD risk, while more activity limitations (OR: 1.727; 95% CI: 1.131–2.639; p = 0.011) and severe anxiety (OR: 1.455; 95% CI: 1.334–1.586; p < 0.001) were associated with higher risk. In females, recent physical exercise (OR: 0.370; 95% CI: 0.235–0.581; p < 0.001) was linked to lower PSD risk, while heart disease (OR: 1.698; 95% CI: 1.136–2.539; p = 0.010) and severe anxiety (OR: 1.516; 95% CI: 1.372–1.674; p < 0.001) were associated with higher risk. Conclusion This study highlights the gender differences in PSD prevalence and correlates among older Chinese stroke survivors. Tailored interventions are needed to address PSD, with future research focusing on targeted screening and intervention.

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