Background and aim: We aimed to investigate the predictors for early (3-month) and delayed (3-year) depression after stroke.
Methods: Stroke or transient ischemic attack (TIA) subjects (n=1023) were recruited from the Chinese University of Hong Kong - STroke Registry Investigating cognitive DEcline (CU-STRIDE). Clinical factors, drug use and neuroimaging markers of small vessel diseases (SVD) were collected at baseline. Geriatric depressive score (GDS) 15-items (≥ 6) was used to ascertain the presence of depression. Logistic regression was used to explore risk factors for presence of depression at 3-month and delayed-onset depression at 3-year, respectively.
Results: A total of 394 (38.5%) patients had depression at 3-month after stroke/TIA, leaving 629 depression-free subjects. Among these 629 subjects, 350 received re-assessment of GDS at 3-year, and 49 (14%) developed depression. At 3-month, National Institute of Health Stroke Scale (NIHSS) score (OR=1.09, 95% CI: 1.04-1.14, p<0.001), Montreal Cognitive Assessment performance (MoCA) (OR=0.92, 95% CI: 0.89-0.96, p<0.001), and younger age (OR=0.979, 95% CI: 0.961-0.997, p=0.024) were associated with depression, while statins use (OR=0.69, 95% CI: 0.49-0.96, p=0.028) was associated with a decreased risk. At 3-year, presence of lacunes at baseline (OR=2.2, 95% CI: 1.1-4.3, p=0.022) and MoCA performance (OR=0.88, 95% CI: 0.81-0.96, p=0.003) were significant risk factors for development of delayed-onset depression, while long-term use of statins (OR=0.4, 95% CI: 0.2-0.9, P=0.021) was associated with a reduced risk of delayed-onset depression.
Conclusion: Clinical severity and age influence early-onset depression, while SVD and cognitive impairment increase risk of delayed-onset depression. Statins use protects from development of depression.