Abstract Body: Introduction: Cerebrovascular diseases are the third leading cause of disability worldwide, which can occur due to the effects of Post-stroke Cognitive Impairment (PSCI) and Post-Stroke Depression (PSD). Higher morbidity and mortality are associated with both conditions following a stroke, but there is a lack of research on this topic in developing countries. We studied the prevalence of stroke and PSCI and PSD in a representative sample of the Brazilian population aged over 50 years, as well as the factors associated with both conditions.
Methods: We performed a retrospective analysis of the ELSI-Brazil study, a nationally representative sample of adults aged 50 and over, including 9412 individuals. Individuals self-reported their sociodemographic characteristics, previous medical history, including prior stroke (transient ischemic attack, ischemic and hemorrhagic stroke), other chronic health conditions and disability in basic (b-ADL) and instrumental activities of daily living (i-ADL). Depression was defined as a score above 4 in the CESD-8 scale. Cognitive impairment was defined through a composite z-score including episodic memory, semantic memory, prospective memory, verbal fluency and orientation. After adjustments by age, sex and education, it was defined as a score below -1.0. Statistical analysis was performed using STATA/SE 17.0 software. Logistic regression was used to study the associated variables with PSD and PSCI.
Results: From the total sample, 536 (5.3%) reported previous stroke. Of these, 58.6% had PSD and 31.8% had PSCI. Individuals who had a stroke were more likely to be older, male, of black race, have lower education, and more chronic health conditions. They also had higher disability in b-ADL and i-ADL, with higher depression and higher cognitive impairment. In the logistic regression, being a woman, having more chronic health conditions and higher disability in i-ADL were associated with PSD, while only being of black race was associated with PSCI.
Conclusion: More than half of individuals with a previous stroke had depression and approximately a third had cognitive impairment. PSD was associated with being a woman, more chronic health conditions and higher disability in i-ADL. PSCI was associated with black race. Understanding the factors associated with PSD and PSCI is important to reduce stroke-related disability and promote better quality of life in individuals with previous stroke.