Depression and Functional Status Among African American Stroke Survivors in Inpatient Rehabilitation

J Stroke Cerebrovasc Dis. 2017 Jan;26(1):116-124. doi: 10.1016/j.jstrokecerebrovasdis.2016.08.039. Epub 2016 Oct 6.

Abstract

Purpose: To examine the prevalence of poststroke depression (PSD) among African American stroke survivors and the association of depression with functional status at inpatient rehabilitation facility (IRF) discharge.

Methods: Secondary data analysis was conducted of a patient cohort who received care at 3 IRFs in the United States from 2009 to 2011. Functional status was measured by the Functional Independence Measure (FIM). Multiple linear regression models were used to examine associations of PSD and FIM motor and cognitive scores.

Results: Of 458 African American stroke survivors, 48.5% were female, 84% had an ischemic stroke, and the mean age was 60.8 ± 13.6 years. Only 15.4% (n = 71) had documentation of PSD. Bivariate analyses to identify factors associated with depression identified a higher percentage of patients with depression than without who were retired due to disability (17.1% versus 11.6%) or employed (31.4% versus 19.6%) prestroke (P = .041). Dysphagia, cognitive deficits, and a lower admission motor FIM score were also significantly more common among those with depression. There was no significant relationship between depression and functional status after adjusting for patient characteristics.

Conclusions: In this study, 15% of the African Americans who received rehabilitation after a stroke had documentation of PSD but this was not associated with functional status at discharge.

Keywords: African American; Black; Depression; functional status; inpatient rehabilitation.

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Black or African American
  • Depression / etiology*
  • Female
  • Humans
  • Inpatients*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Discharge / statistics & numerical data
  • Recovery of Function / physiology*
  • Rehabilitation Centers
  • Retrospective Studies
  • Stroke Rehabilitation / methods*
  • Stroke* / complications
  • Stroke* / ethnology
  • Stroke* / mortality
  • Survivors / psychology*
  • United States
  • Young Adult