Functional Independence and Self-Reported Depressive Symptoms 6-24 Months After Stroke: A Multicentre Cross-Sectional Study.

Background

Post-stroke depression (PSD) is one of the most common neuropsychological complications following stroke and is associated with greater functional disability and poorer functional outcomes. However, the relationship between self-reported depressive symptoms and functional independence remains insufficiently understood. The aim of this study was to examine the association between self-reported depressive symptoms and functional independence in patients in the chronic phase after stroke and examine selected sociodemographic and clinical factors associated with depressive symptom severity.

Methods

A cross-sectional observational study was conducted in Slovakia and the Czech Republic. The sample consisted of 105 patients (64.75 ± 11.23 years) assessed 6-24 months after stroke. Functional independence was evaluated using the Functional Independence Measure and Functional Assessment Measure (FIM + FAM). Self-reported depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS). Spearman correlation analysis and multiple linear regression were applied.

Results

A significant positive correlation was identified between total FIM + FAM score and depressive symptom severity (ρ = 0.479, p < 0.001). Significant associations were also observed for motor (ρ = 0.475, p < 0.001), cognitive (ρ = 0.447, p < 0.001), and EADL domains (ρ = 0.544, p < 0.001), with the strongest relationship found in EADL. After adjustment for sociodemographic and clinical factors, total FIM + FAM was not independently associated with depressive symptom severity (B = 0.032, p = 0.079), and neither were its individual domains. Social status remained independently associated with depressive symptom severity, with patients living alone reporting lower depressive symptom scores.

Conclusions

Functional independence was positively associated with depressive symptom severity in bivariate analyses but not after adjustment for sociodemographic and clinical factors. Social status remained independently associated with depressive symptom severity, highlighting the complex interplay between functional, social, and psychological factors after stroke.