Post-Stroke Depression and Cognitive Aging: A Multicenter, Prospective Cohort Study

Minyoung Shin, Min Kyun Sohn, Jongmin Lee, Deog Young Kim, Yong Il Shin, Gyung Jae Oh, Yang Soo Lee, Min Cheol Joo, So Young Lee, Min Keun Song, Junhee Han, Jeonghoon Ahn, Young Hoon Lee, Won Hyuk Chang, Seyoung Shin, Soo Mi Choi, Seon Kui Lee, Yun Hee Kim

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10 Scopus citations


Background: This study investigated the impact of post-stroke depression (PSD) on cognitive aging in elderly stroke patients. Methods: This study was an interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation. Among 10,636 patients with first-ever stroke, a total of 3215 patients with normal cognitive function three months post-stroke were included in the analysis. PSD was defined using the Korean Geriatric Depression Scale Short Form (K-GDS-SF) at three months. Cognitive aging was defined as a decline in the Korean version of the Mini-Mental Status Examination (K-MMSE) score to less than the second percentile. Results: The hazard ratio (HR) of PSD for cognitive decline was 2.16 (95% CI, 1.34–3.50, p < 0.01) in the older group (age ≥65 years), and 1.02 (95% CI, 0.50–2.07, n.s.) in the younger group (age <65 years). When the older group was divided by sex, the HR was 2.50 (95% CI, 1.26–4.96, p < 0.01) in male patients and 1.80 (95% CI, 0.93–3.51, n.s.) in female patients. However, women showed a higher incidence of cognitive decline in both the PSD and no PSD groups. Among K-GDS-SF factors, “Negative judgment about the past, present, and future” increased the HR of PSD in older male patients. Conclusions: Early PSD increased the HR for cognitive decline in older stroke patients, mainly in males. Specifically, older male patients with negative thinking were at increased risk of cognitive decline. The findings also suggest that older women may be at risk for cognitive decline. Therefore, preventive interventions for cognitive decline should be tailored differently for men and women.

Original languageEnglish
Article number389
JournalJournal of Personalized Medicine
Issue number3
StatePublished - Mar 2022

Bibliographical note

Funding Information:
Funding: This study was supported by a grant from the Korea Disease Control and Prevention Agency (2022-11-006) and by a National Research Foundation (NRF) grant, provided by the Korean government (MSIP, NRF-2020R1A2C3010304).

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • Cognitive decline
  • Dementia
  • Older adults
  • Post-stroke depression
  • Stroke


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