Risk factors for post-stroke neuropsychiatric symptoms (NPS)

A systematic review looked for factors that predicted depression after stroke, using data from 3 population-based studies (a total of 492 patients), 8 hospital-based studies (15,272 patients), and 9 rehabilitation-based studies (2,170 patients).¹ The analysis found that the presence of physical disability, the severity of the stroke, and development of cognitive impairment were consistently associated with post-stroke depression.¹ A similar systematic review was undertaken to find factors predicting anxiety after stroke, using data from 3 population-based studies (a total of 8,130 patients), 8 hospital-based studies (1,199 patients), and 7 rehabilitation-based studies (1,103 patients).⁴ The analysis found that pre-stroke depression, the severity of the stroke, development of anxiety early after stroke, and development of dementia or cognitive impairment were associated with post-stroke anxiety.⁴

Analyses have been performed in an African population, finding similarly that cognitive impairment was significantly associated with post-stroke anxiety.^5,6 The negative impact that post-stroke anxiety can have on patient quality of life reinforces the importance of considering anxiety in patients after stroke, including in Africa.⁵

References:
1.Hackett ML, Anderson CS. Predictors of depression after stroke: a systematic review of observational studies. Stroke 2005; 36 (10): 2296–2301.

2.Guiraud V, Gallarda T, Calvet D, et al. Depression predictors within six months of ischemic stroke: the DEPRESS Study. Int J Stroke 2016; 11 (5): 519–525.

3.Kootker JA, van Mierlo ML, Hendriks JC, et al. Risk factors for symptoms of depression and anxiety one year poststroke: a longitudinal study. Arch Phys Med Rehabil 2016; 97: 919–928.

4.Menlove L, Crayton E, Kneebone I, et al. Predictors of anxiety after stroke: a systematic review of observational studies. J Stroke Cerebrovasc Dis 2015; 24 (6): 1107–1117.

5.Ojagbemi A, Akinyemi J, Owolabi M, et al. Predictors and prognoses of new onset post-stroke anxiety at one year in black Africans. J Stroke Cerebrovasc Dis 2020; 29 (9): 105082.

6.Ojagbemi A, Owolabi M, Akinyemi R, et al. Prevalence and predictors of anxiety in an African sample of recent stroke survivors. Acta Neurol Scand 2017; 136 (6): 617–623.