Factors related to depression symptoms in chronic post-stroke aphasia.

Abstract

To examine relationships of depression symptoms to demographic factors and different types of stroke-related disability and impairment in adults with chronic left-hemisphere stroke and a history of aphasia. Cross-sectional study SETTING: General community PARTICIPANTS: A convenience sample of 92 chronic left-hemisphere stroke survivors (> 6 months) with a history of aphasia and 70 neurologically healthy controls participated. Not applicable MAIN OUTCOME MEASURES: The Beck Depression Inventory-II (BDI-II) measured depression symptoms. The Stroke Impact Scale 3.0 (SIS) assessed stroke-related disability in Cognitive, Physical, and Social Participation domains, as well as self-perceived Recovery. The Western Aphasia Battery Aphasia Quotient and the NIH Stroke Scale total motor score measured language and motor impairment. Spearman correlations examined bivariate relationships between variables. Regression Model 1 examined group differences in BDI-II scores, accounting for demographic factors, including age, education, race, sex, socioeconomic status and antidepressant medication status. Regression Model 2 examined the disability and impairment measures above that predicted BDI-II scores, accounting for the same demographic factors included in Model 1, plus time-since-stroke. BDI-II scores were on average 3.4 points higher in stroke survivors than controls. Model 1 confirmed that this difference was significant, and found that age was inversely related to BDI-II scores. Bivariate correlations demonstrated that higher BDI-II scores were related to lower SIS Cognitive, Social Participation, and Recovery scores. Model 2 found that these three measures independently predicted BDI-II scores. In the chronic phase of LH stroke with aphasia, cognitive and communication disabilities, social participation, and self-perceived recovery are the primary correlates of depression symptoms. These findings highlight the importance of assessing for depression even long after left hemisphere stroke and suggest potential targets to improve psychological intervention and rehabilitation.