Depression drives perceived quality of life following minor stroke

TL;DR

This study shows that depression significantly affects how patients with minor stroke perceive their recovery and quality of life over time.

Contribution

The study highlights the growing impact of depression on long-term quality of life in minor stroke patients, beyond traditional clinical measures.

Findings

Depression and fatigue were inversely linked to satisfaction and quality of life in minor stroke patients.

The negative effect of depression on quality of life increased over time after stroke.

Stroke severity and functional impairment were consistently associated with perceived symptomatic improvement.

Abstract

Stroke outcomes are typically assessed using objective scales focused on severity and functional ability that may overlook subtle cognitive changes and fail to account for patients’ perceptions of recovery and quality of life. This study aimed to compare patient-reported outcomes (PROs) to objective recovery metrics in patients with minor stroke and identify factors associated with perceived recovery and quality of life.

Data from 134 patients with minor stroke were prospectively collected at 1-, 6-, and 12-months post-infarct. Objective assessments measured stroke severity, functional outcomes, activities of daily living, and global cognitive function. PROs included assessments of function, depression, fatigue, symptomatic improvement, and quality of life. Regression models were used to evaluate the relationship between subjective PROs and physician-obtained measures.

Analyses revealed an important role for mental health factors in subjective measures of recovery, though cognitive dysfunction was not significantly associated with either subjective improvement or quality of life despite being commonly endorsed. Depression and fatigue were inversely associated with both satisfaction and quality of life, along with stroke severity and overall functional impairment during both short- and long-term recovery periods. The impact of depression on quality of life increased over time, while stroke severity and functional status were associated with perceived symptomatic improvement at all time points.

For patients with minor stroke, depression is negatively associated with perception of symptomatic recovery and quality of life, particularly at later time points. Addressing post-stroke depression may improve patient-reported outcomes, though further research is needed to determine its impact on broader measures of post-stroke morbidity.

The online version contains supplementary material available at 10.1186/s41687-025-00861-w.