Prevalence of poststroke anxiety and its associations with global cognitive impairment: An individual participant data analysis

Abstract

Anxiety is frequent after stroke; however, little is known about its determinants. This study aims to assess the prevalence and correlates of post stroke anxiety (PSA) within 3–6 months following ischemic stroke. Three cohort studies from the STROKOG consortium were involved. Demographic and clinical data were standardized. PSA and PSD were assessed using inventories. The criteria for post-stroke cognitive impairment (PSCI) were at least one cognitive domain impaired if applicable, or a Montreal Cognitive Assessment (MoCA) score. Descriptive analyses were conducted to ascertain the prevalence of anxiety. Comparisons between anxious and non-anxious patients in the total sample were made using χ 2 and t -tests. A two-step individual participant data (IPD) meta-analysis was employed to identify factors associated with PSA. 584 patients were included. The total prevalence of PSA was 35 % (95%CI = [31.23;38.97]) and ranged from 27 % to 45 % across cohorts. In the total sample, there was a higher proportion of females in the anxiety group than the non-anxiety group (χ 2 = 19.62; p < 0.001). Anxious patients had lower education, (χ 2 = 6.59; p = 0.03), higher stroke severity ( t = 2.77; p = 0.002), and higher rates of PSD (χ 2 = 118.09; p < 0.001), and PSCI (χ 2 = 23.81, p < 0.001). The analysis demonstrates that the odds of presenting with PSA is larger in patients with PSCI (OR = 1.84, 95%CI = [1.14; 2.91]). Anxiety is frequent after stroke, especially in females, and is associated with depression and cognitive impairment. • Three cohorts from the STROKOG consortium were included in the study. • PSA prevalence ranged from 25 to 45 % across cohorts. • In total, PSA was observed in 44.5 % of females and 28.5 % of males. • An IPD meta-analysis revealed that cognitive impairment is associated with PSA.

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