Oral Presentation Australian and New Zealand Stroke Organisation Conference 2025

Anxiety and depression post-stroke: the role of cognition, age, ethnicity and disability.  (123153)

Lily Yee 1 , Suzanne Barker-Collo 2 , Craig Anderson 3 , Alan Barber 4 , Derrick Bennett 5 , Dominique Cadilhac 6 , Jeroen Douwes 7 , Daniel Exeter 8 , Rita Krishnamurthi 1 , Balakrishnan Nair 1 , Varsha Parag 9 , Anna Ranta 10 , Yogini Ratnasabapathy 11 , El-Shadan Tautolo 12 , Braden Te Ao 13 , Amanda Thrift 14 , Bronwyn Tunnage 1 , Valery Feigin 1
  1. National Institute for Stroke and Applied Neuroscience, Auckland University of Technology, Auckland, New Zealand
  2. School of Psychology, The University of Auckland, Auckland, New Zealand
  3. Faculty of Medicine, The George Institute for Global Health, Sydney, New South Wales, Australia
  4. University Research Centre for Brain Research, The University of Auckland, Auckand, New Zealand
  5. Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
  6. Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
  7. Centre for Public Health Research, Massey University, Wellington, New Zealand
  8. Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
  9. National Institute for Health Innovation, The University of Auckland, Auckland, New Zealand
  10. Department of Medicine, University of Otago, Wellington, New Zealand
  11. Department of Medicine, Te Whatu Ora, Health New Zealand - Waitematā , Auckland, New Zealand
  12. AUT Pacific Health Research Centre, Auckland University of Technology, Auckland, New Zealand
  13. School of Population Health, The University of Auckland, Auckland, New Zealand
  14. Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia

Background/Aims. Emotional distress, including anxiety and depression, is prevalent among stroke survivors. Yet, little is known about how cognition, age, sex, ethnicity and functional outcomes may influence psychological recovery over time.

 

Methods. Participants were people with ischemic stroke (IS) from the Auckland Regional Community Stroke Study (ARCOS V), assessed at 1- (N=355) and 12-months (N=299) post-stroke using the Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Assessment (MoCA), and functional status using the modified Rankin Scale (mRS). Analysis comprised within-subject repeated-measures ANOVA to determine changes in HADS scores for those assessed over time (N=299). Anxiety and depression trajectories were examined in the context of cognition, demographics (age, sex, ethnicity) and functional status.

 

Results. There was no detectable change in mean depression scores, while mean anxiety scores improved significantly between assessments (p=0.007). Cognitive function was not directly related to mood outcomes (all p’s >0.225). Younger age was associated with higher anxiety at each time point, and when adjusting for age, the change in anxiety over time was no longer significant. Notably, ethnicity and 1-month mRS score significantly interacted with changes in anxiety over time, suggesting differential psychological recovery across ethnic and functional status groups.

 

Conclusion. Anxiety improved modestly with time post-stroke. This change was not associated with initial post-stroke cognitive function. However, ethnicity and post-stroke functional disability showed significant interactions with long-term anxiety trajectories. These findings highlight the importance of clinical and demographic factors, particularly ethnicity and functional status when understanding emotional outcomes post-stroke.