From the Department of Psychology (M.B., S.N.), University of Münster; Department for Neurology (M.B.), Max Planck Institute for Human Cognitive and Brain Sciences; and International Max Planck Research School on Neuroscience of Communication: Structure, Function, and Plasticity (M.B.), Leipzig, Germany.
Neurology. 2022 Aug 15;99(7):e720-e729. doi: 10.1212/WNL.0000000000200756.
To determine the trajectory of depressive symptoms several years before and after incident stroke.
We analyzed data from 10,797 participants from the English Longitudinal Study of Ageing without a history of stroke at baseline (wave 1). We matched participants with first-ever stroke during the 12-year follow-up (waves 2-7) to stroke-free individuals using propensity scores accounting for age, sex, education, ethnicity, and vascular risk factors. Trajectories of depressive symptoms before and after stroke were analyzed using multilevel models.
Among the 10,797 participants (mean age 64.6 ± 9.9 years, 54.8% women), we identified 425 individuals with incident stroke. At the assessment before stroke, these individuals demonstrated an increase in depressive symptoms when compared with matched controls. There was a further increase in depressive symptoms in stroke survivors after the acute event, which persisted for several years. Symptom-level analyses revealed that differences in depressive symptoms between stroke survivors and stroke-free controls before and after stroke were most pronounced for mood-related and fatigue-related symptoms.
Incident stroke is associated with long-term increases in depressive symptoms. A small part of this increase occurs in the years before stroke, perhaps indicating the incipient pathologic process. Particular attention should be paid to depressive symptoms in the long-term care of patients, and especially to fatigue-related symptoms.
确定在发生中风前后数年的抑郁症状轨迹。
我们分析了基线（第 1 波）时无中风病史的 10797 名英国老龄化纵向研究参与者的数据。我们使用考虑年龄、性别、教育、种族和血管危险因素的倾向评分，将在 12 年随访期间（第 2-7 波）发生首次中风的参与者与无中风个体相匹配。使用多层次模型分析中风前后抑郁症状的轨迹。
在 10797 名参与者（平均年龄 64.6±9.9 岁，54.8%为女性）中，我们确定了 425 名发生中风的个体。在中风前的评估中，与匹配对照组相比，这些个体的抑郁症状有所增加。在急性事件后，中风幸存者的抑郁症状进一步增加，并持续了数年。症状水平分析表明，中风幸存者和无中风对照组在中风前后的抑郁症状差异在情绪相关和疲劳相关症状方面最为明显。
中风的发生与抑郁症状的长期增加有关。这种增加的一小部分发生在中风前的几年，可能表明潜在的病理过程。在患者的长期护理中，应特别注意抑郁症状，特别是与疲劳相关的症状。
