Key result
Over 12 months post-stroke, 4.2% of patients had reliable decreases in anxiety symptoms and 5.7% had reliable decreases in depression symptoms, though findings varied by analytical method.
Why the study?
Depression is commonly studied after stroke whereas anxiety is less studied, prompting an evaluation of their prevalence and methods for assessing within-subject change over time.
Cohort (n=343)
Different statistical methods for evaluating longitudinal changes in post-stroke depression and anxiety yield divergent results, highlighting the importance of calculating clinically reliable change rather than relying solely on cut-off scores.
Highlights post-stroke anxiety alongside depression; leaves open optimal methods for tracking within-patient change.
Background Depression is commonly studied post stroke, while anxiety is less studied. This study presents prevalence of depression and anxiety at 1- and 12-months post ischemic stroke alongside three methods for examining within-subjects change over time. Methods Participants were ischemic stroke patients of the Auckland Regional Community Stroke Study (ARCOS-V) with Hospital Anxiety and Depression Scale data at 1- (n =343) and 12-months (n =307). Change over time was examined using within-subjects repeated measures ANOVA, calculation of the Reliable Change Index, and a Sankey diagram of those meeting cut-off scores (>7) for caseness over time. Results Using repeated measures ANOVA, depression scores didn't change significantly over time, while anxiety symptoms decreased significantly. When reliable change was calculated, 4.2% of individuals had reliable decreases in anxiety symptoms, while 5.7% had reliable decreases in depression symptoms. Those who had a reliable decrease in one tended to have a reliable decrease in the other. In the Sankey, the proportion of those meeting the cut-off score for anxiety did not change over time (12.8 and 12.7% at 1- and 12-months), while those meeting the cut-off for depression increased slightly (3.7-4.5%) and those meeting cut-offs for both decreased from 10.4 to 8.1%. Conclusion The three methods produced very different findings. Use of cut-off scores is common but has limitations. Calculation of clinically reliable change is recommended. Further work is needed to ensure depression and anxiety are monitored over time post-stroke, and both should be the subject of intervention efforts in both acute and late stages post-stroke.
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Barker‐Collo et al. (2024) conducted a cohort in Ischemic stroke (n=343). Time post-stroke (1 to 12 months) was evaluated on Change in depression and anxiety scores over time. Over 12 months post-stroke, 4.2% of patients had reliable decreases in anxiety symptoms and 5.7% had reliable decreases in depression symptoms, though findings varied by analytical method.
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