Post-stroke Depression in the Very Elderly Rate and Predictive Factors

Abstract Background: Post-stroke depression (PSD) affects 25–32% stroke survivors. PSD is quality-of-life altering and negatively impacts stroke recovery and mortality. Stroke incidence increases exponentially with age, especially >65 years, but no studies have yet specifically evaluated PSD in older stroke survivors. Because the very elderly are more prone to developing depression, we hypothesized a relatively high PSD rate for them. Methods: Consecutive stroke patients ≥75 years old, admitted to an acute stroke unit, were screened for depression with the Montgomery-Åsberg Depression Rating Scale or Aphasic Depression Rating Scale for aphasic patients, ≥15 days to 1-year post-stroke. Potential factors predictive of PSD were assessed. Results: Among 441 consecutive stroke patients, only 78 (17%) patients were evaluated because of high mortality and exclusion criteria. Among them, 44.8% (35/78) developed PSD: 22/78 (28.2%) mild and 11/78 (14.1%) moderate. Multivariate analysis retained only ≥1 mRS-point gain as being independently associated with PSD (OR, 6.2 (95% CI, 1.3–29.2), P=0.020). Conclusion: Our results confirmed the expected high PSD rate in patients ≥75 years, and suggest that PSD should be sought systematically or prophylactic antidepressants prescribed >15 days post-stroke for patients with ≥1 mRS-point gain.