NEW research reveals that depression following stroke has a significant long-term impact on survival, recovery, and quality of life, reinforcing the urgent need for early and sustained mental health support.
Most existing studies on post-stroke depression (PSD) focus on short-term effects, with limited insight into long-term outcomes. To address this gap, researchers analysed data from the South London Stroke Register, which tracked patients from January 1997–April 2023. Depression was defined by a score >7 on the Hospital Anxiety and Depression Scale at 3 months post-stroke. Outcomes, including mortality, stroke recurrence, physical disability, instrumental activity of daily living (IADL), and quality of life (QoL), were monitored annually for up to 10 years. Multivariable statistical models assessed associations between PSD and these outcomes, adjusting for relevant confounders.
Among 2,581 stroke survivors assessed at 3 months, 35.6% had symptoms of depression. These individuals had an 18% higher risk of mortality (adjusted hazard ratio [aHR]: 1.18; 95% CI: 1.03–1.36) but no significant increase in stroke recurrence. PSD was associated with nearly threefold increased odds of physical disability (aOR: 2.94; 95% CI: 2.12–4.09) and IADL impairment (aOR: 2.89; 95% CI: 2.13–3.92). QoL was also significantly lower, with physical scores reduced by -5.93 points and mental scores by -7.56. Importantly, patients who recovered from depression within 1 year showed markedly better outcomes: reduced risk of stroke recurrence (aHR: 0.47), less disability, and substantially improved QoL, especially mental health (β=10.91). Depression at 1 and 5 years remained strongly associated with increased mortality, functional decline, and poorer QoL.
The findings show that PSD has persistent and wide-ranging effects, extending well beyond the acute recovery period. Early identification and treatment of PSD could improve not just psychological wellbeing but also physical recovery and survival, making it a key focus for post-stroke care pathways.
Reference
Liu L et al. Long-term outcomes of depression up to 10-years after stroke in the South London Stroke Register: a population-based study. Lancet Reg Health Eur. 2025; DOI:10.1016/j.lanepe.2025.101324.
