Reduction in retained activity participation is associated with depressive symptoms 3 months after mild stroke: An observational cohort study

Objective: To quantify the association of depressive symptoms with retained activity participation 3 months post-stroke, after adjusting for neurological stroke severity and age.

Design: A cross-sectional observational study of retained activity participation and depressive symptoms in stroke survivors with ischaemic stroke. Participants: One hundred stroke survivors with mild neurological stroke severity.

Methods: One hundred stroke survivors were recruited from 5 metropolitan hospitals and reviewed at 3 months post-stroke using measures of activity participation, Activity Card Sort-Australia, and depressive symptoms, Montgomery-Asberg Depression Rating Scale Structured Interview Guide (MADRS-SIGMA).

Results: The median percentage of retained overall activity participation was 97%, (interquartile range 79-100%). Using multiple median regression, 1 point increase in the MADRS-SIGMA was associated with a median decrease of 0.7% (95% CI -1.4 to -0.1, p=0.02) of retained overall activity participation, assuming similar neurological stroke severity and age.

Conclusion: The findings of this study establish the association of depressive symptoms with retained activity participation 3 months post-stroke in stroke survivors with mild neurological stroke severity. Clinical rehabilitation recommendations to enhance activity participation need to account for those with even mild depressive symptoms post-stroke.