Specific Within-Domain Cognitive Impairments Predict Depression Severity Six-Months After Stroke

Abstract

AbstractBackgroundFollowing stroke, chronic cognitive impairments across multiple domains have been associated with depression. Currently, it is unknown if specific subtypes of cognitive impairments differentially relate to post-stroke depression severity. This study aimed to explore the differential associations between within-domain cognitive impairment to depression severity six-months after stroke.MethodParticipants (n= 385, AgeM= 73.86 years [SD= 12.51], National Institutes of Health Stroke SeverityM= 6.83 [SD= 6.01]) were recruited from an acute stroke ward. Participants completed a self-report mood measure (Hospital Anxiety and Depression Scale; HADS) and a stroke-specific cognitive assessment (Oxford Cognitive Screen; OCS). Separate multiple regressions predicting depression were conducted across 1) OCS domain-specific cognitive impairments of language, memory, attention, praxis, numeracy and executive function, and 2) the novel subtask-specific impairments within each OCS domain. Anxiety severity and years of education attained were included as covariates.ResultsWithin-domain impairments that were uniquely associated with depression severity were calculation (b(.57)= 1.44, 95%CI[0.31, 2.56],p= .012), episodic memory (b(.52)= 1.36, 95%CI[0.34, 2.37],p= .009), picture naming (b(.45)= 1.18, 95%CI[0.31, 2.06],p= .008), number writing (b(.46)= 2.54, 95%CI[0.26, 2.07],p= .012), and visuospatial attention (b(.35)= 1.24, 95%CI[0.54, 1.93],p= .001). Analysis in pooled multiply imputed data (N= 430) corroborated complete case analysis findings.ConclusionsSpecific within-domain cognitive impairments have differential relationships with post-stroke depressive symptomology. Accommodating for these impairments in post-stroke depression interventions may potentially enhance therapeutic outcomes.