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Relationship of subjective and objective cognition with post-stroke mood differs between early and long-term stroke
Open accessPreprint — published as 10.1080/13854046.2024.2417865 · Paper page
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.
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Metadata
- Authors
- Kusec, A., the OX-CHRONIC Team, & Demeyere, N.
- Affiliations
- John Radcliffe Hospital (GB)
- Corresponding author
- Kusec, Andrea
- Venue
- The Clinical Neuropsychologist
- Publisher
- openRxiv
- Published
- 2024-01-09
- Volume
- 39
- Issue
- 6
- Pages
- 1651-1672
- ISSN
- 0920-1637 (ISSN-L)
- OpenAlex
- W4403699742
- Cited by
- 14
- References
- 81
- Citations by year
- 2026: 9 · 2025: 5
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- The Clinical Neuropsychologist (publishedVersion, cc-by)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research (NIHR302224)
- Department of Health and Social Care
- Stroke Association (SA PPA 18/)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Keywords
- stroke, post-stroke depression, post-stroke anxiety, objective cognitive impairment, cognitive failure, long-term stroke outcomes, early post-stroke period, reciprocal effects, stroke survivors
- MeSH terms
- Aged, Aged, 80 and over, Anxiety, Cognition, Depression, Female, Humans, Longitudinal Studies, Male, Middle Aged, Neuropsychological Tests, Stroke, Cognitive Dysfunction
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