Relationship of subjective and objective cognition with post-stroke mood differs between early and long-term stroke

Abstract

Abstract Background Depression and anxiety affects 1 in 3 stroke survivors. Performance on standardized objective cognitive tests and self-reported subjective cognitive complaints are associated with concurrent depression and anxiety, but it is unknown whether and how objective and subjective cognition relate to longer-term emotional outcomes. Method N = 99 stroke survivors ( M age = 68.9, SD = 13.1; Median NIHSS = 5) from the OX-CHRONIC cohort completed measures of depression and anxiety (Hospital Anxiety and Depression Scale; HADS), objective cognition (Oxford Cognitive Screen) and subjective cognitive complaints (Cognitive Failures Questionnaire) at 6-months (Time 1), at ∼4.5 years (Time 2) and ∼5.5 years (Time 3) post-stroke. The contribution of objective and subjective cognition to depression and anxiety was determined via mixed-effects models. Results We found no evidence that age, stroke severity, years of education, and participant sex related to changes in HADS-Depression or HADS-Anxiety scores. Objective cognitive impairments at Time 1 ( b = -0.79, p < .05) and increases in subjective cognitive complaints at Time 3 ( b = 0.77, p < .05) related to increased HADS-Depression scores (Marginal R 2 = 0.22). Only increases in subjective cognitive complaints at Time 3 ( b = 0.96, p < .05) related to increased HADS-Anxiety scores (Marginal R 2 = 0.20). When conducting models in reverse, HADS-Depression and HADS-Anxiety scores did not reciprocally explain changes in subjective cognitive complaints. Conclusions Objective cognitive abilities are more strongly associated with depression at 6-months post-stroke, while subjective cognitive complaints are more relevant to both long-term post-stroke depression and anxiety.