Health-related quality of life, anxiety and depression up to 12 months post-stroke: Influence of sex, age, stroke severity and atrial fibrillation - A longitudinal subanalysis of the Find-AFRANDOMISED trial

Monika Sadlonova; Katrin Wasser; Jonas Nagel; Mark Weber-Krüger; Sonja Gröschel; Timo Uphaus; Jan Liman; Gerhard F Hamann; Pawel Kermer; Klaus Gröschel; Christoph Herrmann-Lingen; Rolf Wachter

doi:10.1016/j.jpsychores.2020.110353

Health-related quality of life, anxiety and depression up to 12 months post-stroke: Influence of sex, age, stroke severity and atrial fibrillation - A longitudinal subanalysis of the Find-AF_RANDOMISED trial

J Psychosom Res. 2021 Mar:142:110353. doi: 10.1016/j.jpsychores.2020.110353. Epub 2021 Jan 2.

Authors

Affiliations

¹ Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany; Department of Thoracic- und Cardiovascular Surgery, University of Göttingen Medical Center, Göttingen, Germany; DZHK (German Center for Cardiovascular Research), Partner site Göttingen, Germany. Electronic address: monika.sadlonova@med.uni-goettingen.de.
² Department of Neurology, University of Göttingen Medical Center, Göttingen, Germany.
³ Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany.
⁴ Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.
⁵ Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
⁶ Department of Neurology and Neurorehabilitation, Bezirkskrankenhaus Günzburg, Günzburg, Germany.
⁷ Department of Neurology, University of Göttingen Medical Center, Göttingen, Germany; Department of Neurology, Nordwest-Krankenhaus Sanderbusch, Sande, Germany.
⁸ Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany; DZHK (German Center for Cardiovascular Research), Partner site Göttingen, Germany.
⁹ DZHK (German Center for Cardiovascular Research), Partner site Göttingen, Germany; Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany; Department of Cardiology, University Hospital Leipzig, Leipzig, Germany.

PMID: 33421630
DOI: 10.1016/j.jpsychores.2020.110353

Abstract

Background: Stroke can negatively impact the health-related quality of life (HRQoL). Anxiety or depression after stroke have been associated with poorer HRQoL, higher mortality and greater dependence in activities of daily living. We aimed to analyze HRQoL, anxiety and depressive symptoms in patients with and without atrial fibrillation (AF) up to 12 months post-stroke.

Methods: Find-AF_RANDOMISED was a prospective, randomized multicenter study, which included 398 patients ≥60 years with acute cerebral ischemia. HRQoL data were collected using the 3-level EuroQol-5D (EQ-5D-3L) and Stroke Impact Scale (SIS-16). Anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS). The severity of stroke was measured using the modified Rankin Scale (mRS).

Results: In this study (mean age 72.7 ± 7.5 years, 40.2% females), there was a significant improvement in HRQoL using EQ-5D-3L after 3 months (β = 0.37, p < .01), 6 months (β = 0.43, p < .01) and 12 months (β = 0.44, p < .01) post-stroke compared to baseline. HADS anxiety scores after 3 months (β = -0.22, p < .01) and 12 months (β = -0.28, p < .01) were significantly reduced. Older patients reported reduced HRQoL and more depressive symptoms. Females indicated lower HRQoL and more anxiety. mRS score at baseline was an independent predictor for HRQoL. There was a significant but small effect of AF on EQ-5D-3L and on HADS anxiety.

Conclusions: Patients showed significant improvement in HRQoL and reduced anxiety after 3 and 12 months after stroke. We could demonstrate that the severity of stroke as well as sex and age impact long-term post-stroke HRQoL.

Clinical trial registration: Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01855035.

Keywords: Anxiety; Atrial fibrillations; Depression; Quality of life; Stroke; mRS.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living / psychology*
Age Factors
Aged
Anxiety / psychology*
Atrial Fibrillation / psychology*
Depression / psychology*
Female
Humans
Longitudinal Studies
Male
Prospective Studies
Quality of Life / psychology*
Sex Factors
Stroke / psychology*
Time Factors

Associated data

ClinicalTrials.gov/NCT01855035