Patterns of change in depression after stroke

Objective: To provide estimates of change in depressive symptoms and determine how changes in depressive symptom influence recovery of functional status. Design: Prospective cohort study. Setting: Eleven inpatient medical rehabilitation facilities located across the United States. Participants: Five hundred forty-four persons with a first-time stroke. Measurements: General linear regression model estimates assessed associations between depressive symptom change and functional status 3 and 12 months after discharge. Results: The majority of persons with stroke were aged 75 and older, white, female, and married. The most prevalent stroke type was ischemic. For participants without depression at discharge, those who reported fewer depressive symptoms 12 months after stroke than before had an adjusted functional status score of 108.2, whereas those with more symptoms had an adjusted functional status score of 104.6. For participants who were depressed at discharge, those who reported fewer depressive symptoms 12 months after stroke than before had an adjusted functional status score of 100.3, whereas those with more symptoms had an adjusted functional status score of 88.0. Conclusion: Tracking depressive symptom change in the hospital and after discharge is clinically relevant and is an important component of patient care and recovery of functional status.