A Prospective Study Of Depression And Cognitive Impairment After Acute Stroke

Abstract：Background：stroke is a cerebrovascular accident, suddenneurological changes caused by cerebrovascular disease， includingischemic stroke and hemorrhagic stroke. Stroke not only causes physicalfunction in patients with disabilities, but also causes varying degrees ofinfluence on many aspects of the patient’s mental status, life satisfaction,social function, occupational function, so as to give patients and familiesa heavy burden, resulting in patients’quality of life declining.With the aging of our population, patients with stroke alsoincreased year by year. Stroke showed a high incidence, high morbidity,high mortality, and the survivors had many complications. Post-strokedepression and cognitive impairment,with high incidence, were twocommon complications. According to the survey, the incidence of PSDranged from20%to65%, while the incidence of PSCI was up to21%-58%. PSD and PSCI had a direct impact on physical rehabilitation andquality of life of patients.With advancing in medical technology and the convert to theconcept of health, the medical model has been transformed into bio-social-psychological model. no longer limiting to the treatment purposes,improving the living conditions of patients,promoting social developmentand improving the quality of life of patients and their families are theultimate goals. Improving the quality of life of patients and their families is not only the ultimate goal of the medical staff for treatment, but alsoproviding a basis for clinical treatment and rehabilitation therapy. Soearly detection, early treatment for PSCI and PSD has a great influenceon the prognosis and quality of life of patients.Objective:1.To evaluate the incidence of depression after acute stroke at14days,3months,6months,12months and the incidence of cognitiveimpairment after stroke at14days and12months.2.To explore theindenpent risk factors of post stroke depression and post stroke cognitiveimpairment.Materials and methods:This research is a prospective, longitudinalstudy designed to determine the prevalence of post stroke depression at14days,3months,6months,12months and the incidence of post strokecognitive impairment at14d and12months;To explore the indenpent riskfactors of post stroke depression and post stroke cognitive impairment.44hospitalized stroke patients in Sichuan Provincial Hospital, Departmentof Neurology, during September2012-December2012,were enrolled inthis study. Baseline data, including age, sex, education, marital status,personal income, before the onset of mRS, history of stroke, hypertension,diabetes mellitus, onset of NIHSS score.At14days,3months,6months,12months, respectively, HDRS scores were collected. At14days and12months, respectively, MoCA scores were collected. PSD meets thediagnostic criteria of depression in DSM-IV. The PSCI is based on thediagnostic criteria of VCI. Results:41cases of stroke patients completed the12-month follow-up.The incidence of PSD at14days,3months,6months,12months, was31.8%,31.0%,28.5%,26.8%,respectively. PSCI incidence at14days,12months was31.8%,22.0%, respectively. The PSD group and non-PSDgroup at14d had significant differences in gender, age, education,personality characteristics, history of diabetes and MoCA score of14d. At14d PSCI group and non-PSCI had significant differences in age,educational level, history of stroke, the onset of NIHSS score and HDRSscore. At12months after the stroke, the MoCA scores of14d andeducational level were independent risk factors for PSD andPSCI,respectively.Conclusion: PSD and PSCI are two common complications after stroke,and at different points its prevalence and risk factors are not identical, sofurther research for the risk factors of PSD and PSCI is needed, this willallow clinicians to take appropriate therapeutic measures to reduce itsincidence, thereby improving patient outcomes and the quality of life ofpatients.