Key result
Stroke survivors gain ~0.06 points in quality of life at 1 year, hindered by baseline depression.
Why the study?
Stroke is associated with a decline in health-related quality of life due to cognitive impairment, declined physical function, and psychological stress, prompting evaluation of 1-year changes and predictors of recovery.
Cohort (n=1,655)
Yes
Answers are grounded in this paper and cite their sources.
Ischaemic stroke survivors experience significant overall recovery in health-related quality of life at one year driven by functional and mobility gains, though baseline depression and anxiety independently predict poorer recovery and pain/discomfort worsens.
Background Stroke is associated with decline in health-related quality of health (HRQoL) often because of cognitive impairment, declined physical function, and psychological stress. Purpose This study aimed to evaluate changes in HRQoL in stroke survivors over one year of follow-up and to determine predictors of HRQoL recovery at 12-months. Methods Between September 2021 and December 2022, patients with ischaemic stroke were recruited from 35 participating hospitals. HRQoL was measured at baseline and 12-month follow-up using the EQ-5D-5L. Utility index score was calculated from the five domains (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) of the EQ-5D-5L. Results 1,655 patients (median age: 71 [IQR: 61, 79]; 59% male) were recruited; 935 patients with complete EQ-5D-5L data were analysed. The mean utility score improved from 0.72 at baseline to 0.78 at 12-month follow-up (mean difference: 0.06; 95% CI: [0.05 – 0.08]; p<0.001) (Figure 1). From baseline to 12-month, four EQ-5D-5L domains, including mobility (2.42 vs 2.02, p<0.001), self-care (1.97 vs 1.59, p<0.001), usual activities (2.51 vs 2.03, p<0.001), and anxiety/depression (1.66 vs 1.56, p=0.004), showed significant improvement (Figure 1). Pain/discomfort worsened significantly over the first 12-months post-stroke (1.66 vs 1.87, p<0.001). Multivariable linear regression identified cognitive function and psychological distress as key independent predictors of 12-month HRQoL recovery (Figure 2). Baseline utility score was the strongest predictor (β= -0.711, p< 0.001), reflecting a significant ceiling effect. Better baseline cognitive function (MoCA: β = 0.005, p= 0.007) was associated with greater utility gains. Conversely, baseline depression (PHQ-9: β= -0.007, p= 0.002) and anxiety (GAD-7: β= -0.004, p = 0.035) were significant barriers, independently predicting poorer recovery. Conclusions Stroke survivors experience a significant overall recovery in HRQoL driven primarily by functional and mobility-related gains. However, psychological stress including anxiety and depression hindered the overall recovery of HRQoL. Post-stroke HRQoL and mood should be assessed with target interventions to improve emotional well-being and HRQoL.
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Lam et al. (2026) conducted a cohort in Ischaemic stroke (n=1,655). Ischaemic stroke survival and baseline cognitive/psychological factors vs. Baseline status was evaluated on Change in health-related quality of life (HRQoL) measured by EQ-5D-5L utility index score from baseline to 12 months (MD 0.06, 95% CI 0.05-0.08, p=<0.001). Stroke survivors improved in EQ-5D-5L utility from 0.72 to 0.78 at 1 year (MD 0.06; 95% CI 0.05-0.08; p<0.001), though baseline depression and anxiety hindered recovery.
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