Early Changes in Post-Stroke Quality of Life and Associated Factors: A Prospective Study

Background Stroke affects physical, psychological, and social functioning. Early changes in health-related quality of life (HRQoL) remain incompletely characterized. Objectives To assess early HRQoL changes after stroke and identify associated factors. Methods We assessed 111 patients with first-ever stroke at baseline, 1 month, and 3 months. Functional status, cognition, depressive symptoms, and HRQoL were evaluated using the Barthel Index, Functional Ambulation Scale, Mini-Mental State Examination, Beck Depression Inventory, Form-36 (SF-36) and the Stroke Impact Scale 3.0 (SIS 3.0). Paired tests, correlations with false discovery rate correction, and multivariable linear regression were used. Results Ninety-seven patients completed follow-up. Physical and psychosocial HRQoL showed divergent recovery trajectories. SF-36 physical component scores progressively improved across both intervals (baseline to 1 month, p = 0.006; 1 to 3 months, p = 0.033), whereas mental component scores improved only during the first month ( p = 0.021) and showed no further significant improvement thereafter ( p = 0.342). Similarly, SIS 3.0 emotion scores showed no significant change between 1 and 3 months ( p = 0.831) and no significant net change over 3 months ( q = 0.103), unlike the other domains, which continued to improve. In multivariable regression, functional ambulation at 3 months was independently associated with physical HRQoL change (β = 0.483, p < 0.001; adjusted R 2 = 0.450), whereas depressive symptom severity was independently associated with mental HRQoL change (β = −0.692, p < 0.001; adjusted R 2 = 0.667). Conclusion Physical and psychosocial HRQoL did not recover in parallel during the first 3 months after stroke. Ambulation and depressive symptoms warrant separate attention during early rehabilitation planning.