Depression, cognitive impairment and physical functional outcome and their associated factors in stroke patients in community hospital care

Abstract

Aims: There have been inconsistent reports about the relationships between factors associated with clinical and psychosocial outcomes of stroke in previous research studies. The aim of this research study is to examine the relationship between depression, cognitive function and physical functional outcome and their associated factors in stroke patients in two community hospitals in Singapore, where the step down post acute care is given to the patients. Methodology: An Observational Cohort Study on 200 stroke patients in two community hospitals was conducted. The patients were examined after seeking their informed verbal consent upon their admissions and upon their planned discharges, using Barthel Index for ADL dependency, Geriatric Depression Scale, Abbreviated Mental Test and the NIHS Scale for Neurological Impairment Results: On admission, 120 (60%) patients were depressed, 107 (54.5%) were cognitively impaired and 53.5 % of the patients had severe functional impairment (Barthel Index Significant independent predictors of post stroke cognitive impairment were age more than 81 years (O.R. =6.78, 95% C.I. = 2.34; 19.64), less than secondary level education (O.R = 4.73, 95% C.I. = 1.41, 13.11), severe neurological impairment (O.R. = 5.00, 95% C.I. = 1.70, 14.67) and depression(O.R. = 3.19, 95% C.I. = 1.61, 6.30). Significant independent predictors of ADL dependency were cognitive impairment (OR= 6.85, 95%CI=1.82, 24.90), severe neurological impairment (OR=5.18 95%CI=1.07, 25.08) , post stroke dysphagia (O.R. = 3.82, 95% C.I. = 1.28, 11.38), severe functional impairment on admissio(O.R.=18.58, 95%C.I. = 2.13, 161.94) Conclusion: Significant number of stroke patients are depressed and cognitively impaired during hospitalization, which are, significant factors associated with ADL dependency in stroke patients.