Post-stroke depression inhibits improvement in activities of daily living in patients in a convalescent rehabilitation ward

Abstract

[Purpose] There have been no investigations into the improvement of activities of daily living among patients suffering from post-stroke depression on admission to convalescent rehabilitation wards in Japan. This study aimed to assess the improvement of activities in daily living in patients with or without post-stroke depression at the time of admission to a convalescent rehabilitation ward. [Subjects and Methods] This retrospective study included 108 stroke patients divided into two groups according to their Geriatric Depression Scale 15-item short form scores. Activities of daily living were assessed using the Functional Independence Measure. The degree of improvement on the Functional Independence Measure was defined as the difference between scores on admission and at discharge. [Results] The Functional Independence Measure gain score was significantly different from the Functional Independence Measure total score. There was a significant interaction between time period and post-stroke depression factors for the Functional Independence Measure total score. A multiple regression analysis revealed a significant association between Geriatric Depression Scale score and Functional Independence Measure total score. [Conclusion] The present study suggests that post-stroke depression has a negative impact on recovery of activities of daily living and on rehabilitation outcomes in a convalescent rehabilitation ward setting.

Post Stroke Depression

“…Some such features include cognitive impairment, psychomotor retardation, and social withdrawal [29]. One measure used to assess poststroke depression in the elderly is the geriatric depression scale (GDS) [32]. This is a self-reported scale where patients answer yes and no questions to determine if a patient is experiencing some form of depression.…”

“…Post Stroke Depression DOI: http://dx.doi.org /10.5772/intechopen.86935 This scale is highly sensitive and predictive of poststroke depression in the geriatric population [32]. However, the GDS cannot be used by aphasic stroke patients or those with cognitive impairments caused by a stroke.…”

“…This type of depression differs from poststroke depression, in that they are silent, and the patient is not aware that they have suffered a stroke [31]. In a Japanese sample, greater than 80% of the patients that had major depression had MRI evidence of multiple silent infarcts [32]. Up to 75% of these depressed patients had lesions in the basal ganglia and thalamus [31,33].…”

“…Patients with large strokes and increased debility often require management in a skilled nursing facility (SNF). At SNF, the patients do not participate in as much rehabilitation activities, as compared to other stroke patients in an inpatient rehabilitation setting [32]. These patients are therefore at disadvantage because their exposure to rehabilitation is limited.…”

“…The combination of decreased functionality, less access to rehabilitation, and depression impairs the recovery for these patients. They too lose the desire to participate in meaningful interaction due to their disability [32].…”