摘要
Abstract
Objective To evaluate the influencing factors of post-stroke depression(PSD)in the elderly based on the geriatric depression scale 15(GDS-15)and to longitudinally analyze the changes in depressive status.
Methods A retrospective analysis was performed on the clinical data of elderly patients with first-episode acute ischemic stroke(AIS)admitted to the Third People's Hospital of Hefei from January 2019 to December 2021.All patients completed the GDS-15 questionnaire at discharge to evaluate the occurrence of PSD.Patients with a GDS-15 score>10 were included in the PSD group,while those with a score≤10 were included in the non-PSD group.Clinical data were compared between the two groups,and multivariate logistic regression analysis was used to assess the risk factors for PSD in elderly patients with AIS.Longitudinal analysis of GDS-15 scores was performed for patients with a follow-up period of≥12 months after discharge.
Results A total of 168 elderly AIS patients were enrolled,including 57 patients in the PSD group and 111 patients in the non-PSD group.The proportion of patients with an education level of junior college or above in the PSD group was lower than that in the non-PSD group(P=0.042).The proportions of patients with an admission NIHSS score>4 points(P=0.007),an admission modified Barthel index(MBI)score<60 points(P=0.003),and an admission geriatric nutritional risk index(GNRI)≤98(P=0.021)were higher in the PSD group than in the non-PSD group.Multivariate logistic regression analysis showed that an admission NIHSS score>4 points(OR2.489,95％CI 0.017～0.995,P<0.05),an admission MBI score<60 points(OR3.357,95％CI 1.883～5.986,P<0.05),and an admission GNRI≤98(OR2.818,95％CI 1.537～5.165,P<0.05)were risk factors for PSD in elderly patients with AIS,while an education level of junior college or above was a protective factor(OR0.519,95％CI 0.017～0.995,P<0.05).Among the 168 elderly patients with AIS,69 patients had a follow-up period of≥12 months after discharge.At 12 months after discharge,GDS-15 score,MBI score,and GNRI were higher than those at discharge(P all<0.01),while NIHSS score was lower than that at discharge(P<0.01).
Conclusions Depressive levels in elderly patients with AIS may increase after discharge.Those with severe neurological impairment,significant limitations in activities of daily living,and poor nutritional status at admission are more likely to develop PSD,whereas those with an education level of junior college or above have a low risk of PSD.关键词
缺血性卒中/老年/卒中后抑郁/老年抑郁量表Key words
Ischemic stroke/Elderly/Post-stroke depression/Geriatric depression scale 15分类
医药卫生
