Combined healthy lifestyle and post-stroke depression: a cross-sectional study in US adults

IF 2.1 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2026-01-01 Epub Date: 2025-11-29 DOI:10.1016/j.jstrokecerebrovasdis.2025.108512

Chanchan Miao, Fu rong Zhang, Xuejun Gao, Yingying Liu

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引用次数: 0

Abstract

Background

Post-stroke depression (PSD) is a serious complication affecting the survival and functional recovery of stroke patients, with a prevalence of approximately 30 %. It predominantly occurs within the first year after stroke, particularly within the first three months. Although individual lifestyle factors are associated with PSD, the combined impact of composite lifestyle factors (smoking, alcohol consumption, physical activity, diet, sleep, and obesity) on PSD remains unclear. This study aims to examine the association between composite healthy lifestyle behaviors and PSD among stroke survivors in the United States.

Method

By analyzing data from the 2005–2020 National Health and Nutrition Examination Survey (NHANES) in the United States, a total of 708 stroke survivors were included. The Healthy Lifestyle Score was used to assess the association between a composite healthy lifestyle and PSD. This score encompasses six factors: non-smoking, moderate alcohol consumption, regular physical activity, a nutritious diet, an ideal waist circumference, and sufficient sleep. Scores range from 0 to 6, with higher scores indicating a healthier lifestyle. Depression was diagnosed using the Patient Health Questionnaire-9 (PHQ-9) with a cutoff score of ≥9.

Results

The weighted prevalence of PSD among stroke survivors was 20.54 %. Multivariate logistic regression analysis indicated a significant negative correlation between healthy lifestyle scores and PSD risk. Compared to stroke survivors with 0-1 healthy lifestyle behaviors, those with 4-6 healthy lifestyle behaviors had an 80 % reduced risk of PSD (OR=0.20, 95 % CI: 0.08-0.45). Furthermore, each additional healthy lifestyle behavior was associated with a 45 % reduction in PSD risk (OR = 0.55, 95 % CI: 0.44-0.68). Subgroup analyses revealed that this inverse association persisted across all subgroups and was more pronounced among individuals with a household poverty-income ratio (PIR) of 3.5 or higher (P for interaction = 0.01). Sensitivity analyses supported the robustness of these findings.

Conclusion

This study demonstrates that adopting a composite healthy lifestyle is significantly associated with reduced risk of PSD among stroke survivors in the United States, underscoring the importance of healthy lifestyles in preventing PSD.

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健康生活方式与中风后抑郁的结合：一项针对美国成年人的横断面研究

背景：脑卒中后抑郁（PSD）是影响脑卒中患者生存和功能恢复的严重并发症，患病率约为30%。它主要发生在中风后的第一年，特别是在头三个月内。虽然个体生活方式因素与PSD有关，但复合生活方式因素（吸烟、饮酒、体育活动、饮食、睡眠和肥胖）对PSD的综合影响尚不清楚。本研究旨在研究美国中风幸存者中复合健康生活方式行为与PSD之间的关系。方法：通过分析美国2005-2020年全国健康与营养调查（NHANES）的数据，共纳入708例脑卒中幸存者。健康生活方式评分用于评估复合健康生活方式与PSD之间的关系。这个分数包括六个因素：不吸烟、适度饮酒、定期体育锻炼、营养饮食、理想腰围和充足睡眠。得分范围从0到6，得分越高表明生活方式越健康。使用患者健康问卷-9 （PHQ-9）诊断抑郁症，截止得分≥9。结果：脑卒中幸存者PSD加权患病率为20.54%。多因素logistic回归分析显示健康生活方式评分与PSD风险呈显著负相关。与有0-1种健康生活方式行为的中风幸存者相比，有4-6种健康生活方式行为的中风幸存者患PSD的风险降低80% （OR=0.20, 95% CI: 0.08-0.45）。此外，每增加一种健康的生活方式行为与PSD风险降低45%相关（OR = 0.55,95% CI: 0.44-0.68）。亚组分析显示，这种负相关在所有亚组中都存在，在家庭贫困收入比（PIR）为3.5或更高的个体中更为明显（相互作用P值 = 0.01）。敏感性分析支持这些发现的稳健性。结论：本研究表明，在美国卒中幸存者中，采用复合健康生活方式与降低PSD风险显著相关，强调了健康生活方式对预防PSD的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.