Purpose: This study examined the relationship between depressive symptoms and time courses in achieving independence in basic activities of daily living (BADL) and instrumental activities of daily living (IADL).
Methods: At baseline, 1, 3, and 6 months after stroke, 459 stroke patients were prospectively assessed. We used the Geriatric Depression Scale to determine depressive status. Outcomes were times to achieve independence in BADL (Barthel >95) and independ-ence in at least three IADL. We used the Kaplan-Meier method and time-dependent Cox proportional hazards regression to examine the relationship between depression and stroke recovery.
Results: Depressed patients were 0.3 times less likely than nondepressed patients to achieve BADL of >95 and 0.4 times less likely to be independent in three or more IADL. The cumulative percentages for the nondepressed patients to achieve a BADL of >95 at 1, 3, and 6 months after stroke were 47%, 63%, and 72%, and for the depressed patients, they were 19%, 34%, and 52%, respectively. Similarly, the cumulative percentages for nondepressed patients to achieve complete independence in three or more IADL at 1, 3, and 6 months after stroke were 56%, 72%, and 85%, and for the depressed patients, they were 32%, 47%, and 72%, respectively. Depressed patients had poorer recovery patterns and took longer to achieve the outcomes.
Conclusion: Stroke patients with depressive symptoms progressed slower in achieving independence of BADL and IADL compared to patients without depressive symptoms.