Energy, mood, mobility deficits go unnoticed after stroke

Many post-stroke deficits go unrecognized.

Within the first three months after a stroke, a substantial number of 147 stroke patients in a study reported dysfunctions of their energy, mood, mobility, work, and cognition, as reported at the 27th International Stroke Conference.

Most of these domains are not commonly assessed, according to a neurologist at Indiana University and the Veteran Affairs Medical Center in Indianapolis. In addition, the severity of these dysfunctions tended to be worse three months after the stroke, compared with one month post stroke, as disclosed at the conference sponsored by the American Stroke Association.

At months after their strokes, 30 percent of the patients said that their energy levels were lower and their mood was more negative, compared with their status one month after their stroke. Mean patient age was 61 years, 69 percent were men, 70 percent were white. They were managed and assessed at two Indianapolis hospitals.

The declines in these quality of life measures occurred without an overt change in the prevalence of depression. At one month after their stroke, 37 percent of the patients showed signs of depression. At three months after their stroke, 36 percent had indications of depression.

Overall, 70 percent of patients who were depressed at one month were still depressed at three months. The other patients who were depressed at one month were no longer depressed at three months. But a virtually identical number of patients who were not depressed at one month took their place, scoring as newly depressed at three months.

The depressions scores were strongly related to quality of life ratings. Patients who were depressed at three months after their stroke were more than twice more likely to have worse quality of life ratings than patients who weren’t depressed. Patient’s expectations seemed to contribute to the risk of depression. By three months, after their stroke, some patients expected to feel better by now.

Interventions that improve patients’ mood, cognition, and resumption of normal activities may be the best way to improve patients’ quality of life after strokes.