Early Changes in Post-Stroke Quality of Life and Associated Factors: A Prospective Study.

Abstract

BackgroundStroke affects physical, psychological, and social functioning. Early changes in health-related quality of life (HRQoL) remain incompletely characterized.ObjectivesTo assess early HRQoL changes after stroke and identify associated factors.MethodsWe assessed 111 patients with first-ever stroke at baseline, 1 month, and 3 months. Functional status, cognition, depressive symptoms, and HRQoL were evaluated using the Barthel Index, Functional Ambulation Scale, Mini-Mental State Examination, Beck Depression Inventory, Form-36 (SF-36) and the Stroke Impact Scale 3.0 (SIS 3.0). Paired tests, correlations with false discovery rate correction, and multivariable linear regression were used.ResultsNinety-seven patients completed follow-up. Physical and psychosocial HRQoL showed divergent recovery trajectories. SF-36 physical component scores progressively improved across both intervals (baseline to 1 month, p  =  0.006; 1 to 3 months, p = 0.033), whereas mental component scores improved only during the first month (p = 0.021) and showed no further significant improvement thereafter (p = 0.342). Similarly, SIS 3.0 emotion scores showed no significant change between 1 and 3 months (p = 0.831) and no significant net change over 3 months (q = 0.103), unlike the other domains, which continued to improve. In multivariable regression, functional ambulation at 3 months was independently associated with physical HRQoL change (β = 0.483, p < 0.001; adjusted R² = 0.450), whereas depressive symptom severity was independently associated with mental HRQoL change (β = -0.692, p < 0.001; adjusted R² = 0.667).ConclusionPhysical and psychosocial HRQoL did not recover in parallel during the first 3 months after stroke. Ambulation and depressive symptoms warrant separate attention during early rehabilitation planning.