Poster Presentation Australian and New Zealand Stroke Organisation Conference 2025

Association between frailty status and antidepressant prescription among older stroke survivors (#135)

Sabine Allida 1 2 3 , Henok Teshome 1 2 , Julee McDonagh 1 2 , Reejamol John 1 2 , Scott William 1 2 , Caleb Ferguson 1 2 , Richard Lindley 3 4
  1. School of Nursing, University of Wollongong, Wollongong, NSW, Australia
  2. Centre for Chronic & Complex Care Research, Western Sydney Local Health District, Blacktown, NSW, Australia
  3. The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
  4. Westmead Applied Research Centre, University of Sydney, Sydney, NSW, Australia

Aim: To investigate the association between frailty status and antidepressant prescription among older stroke survivors.

Methods: Stroke survivors enrolled in the Western Sydney Clinical Frailty Registry(1) between February 2020 – April 2025 were included in the analysis. Frailty was assessed at baseline hospitalisation using the Clinical Frailty Scale (CFS); 1-4 is ‘non-frail’, 5-6 is ‘mild-moderately frail’, and 7-9 is ‘severely frail’. Depression/mental illness and antidepressant prescription was confirmed through documentation of diagnosis and medication history in participants’ electronic medical records. Binary logistic regression model was used to examine the association between frailty status and antidepressant prescription.

Results: In a cohort of 1426 older adults enrolled in the registry, 357 were diagnosed with stroke (mean age 82 years, 48% women). Of the 357 stroke survivors, 21.3% (n=76) were diagnosed with depression/mental illness and 22.7% (n=81) were prescribed an antidepressant. Of the 76 stroke survivors with depression/mental illness, 63% (n=48) were prescribed with antidepressants. Mild-moderately frail stroke survivors had almost two-fold higher odds of being prescribed with antidepressants than their non-frail counterparts (OR 1.9, 95% CI 0.98 – 3.73). Severely frail participants had almost three-times greater odds of being prescribed antidepressant than non-frail stroke survivors (OR 2.9, 95% CI 1.31 – 6.54).        

Conclusion: Among older stroke survivors, higher levels of frailty was associated with increased odds of antidepressant prescription. The greater medication burden observed among frail stroke survivors highlight the need for targeted education and careful clinical consideration, given the increased risk of adverse side effects in this vulnerable population.

  1. Ferguson C., Lombardo L., Mehta J. et al. Design and rationale of the Western Sydney Clinical Frailty Registry: A prospective observational long-term clinical cohort study. Collegian. 2023;30(2):315-20.