{"title":"特定领域内认知障碍预测中风后6个月抑郁症的严重程度。","authors":"Kyle Kelleher, Nele Demeyere, Andrea Kusec","doi":"10.1080/10749357.2025.2557317","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Following stroke, chronic cognitive impairments across multiple domains have been associated with depression. Currently, it is unknown if specific subtypes of cognitive impairments are differentially related to post-stroke depression severity.</p><p><strong>Objectives: </strong>To explore the differential associations between within-domain cognitive impairment to depression severity six-months after stroke.</p><p><strong>Methods: </strong>Participants (<i>n</i> = 385, Age <i>M</i> = 73.86 years [<i>SD</i> = 12.51], National Institutes of Health Stroke Severity <i>M</i> = 6.83 [<i>SD</i> = 6.01]) were recruited from an acute stroke ward. Participants completed a self-report mood measure (Hospital Anxiety and Depression Scale; HADS) and a stroke-specific cognitive assessment (Oxford Cognitive Screen; OCS). Separate multiple regressions predicting depression were conducted across 1) OCS domain-specific cognitive impairments of language, memory, attention, praxis, numeracy, and executive function, and 2) the novel subtask-specific impairments within each OCS domain. Anxiety severity and years of education attained were included as covariates.</p><p><strong>Results: </strong>Within-domain impairments that were uniquely associated with depression severity were calculation (<i>b</i><sub>(.57)</sub> = 1.44, 95% <i>CI</i> [0.31, 2.56], <i>p</i> = .012), episodic memory (<i>b</i><sub>(.52)</sub> = 1.36, 95% <i>CI</i> [0.34, 2.37], <i>p</i> = .009), picture naming (<i>b</i><sub>(.45)</sub> = 1.18, 95% <i>CI</i> [0.31, 2.06], <i>p</i> = .008), number writing (<i>b</i><sub>(.46)</sub> = 2.54, 95% <i>CI</i> [0.26, 2.07], <i>p</i> = .012), and visuospatial attention (<i>b</i><sub>(.35)</sub> = 1.24, 95% <i>CI</i> [0.54, 1.93], <i>p</i> = .001). Analysis in pooled multiply imputed data (<i>N</i> = 430) corroborated complete case analysis findings.</p><p><strong>Conclusions: </strong>Specific within-domain cognitive impairments have differential relationships with post-stroke depressive symptomology. Accommodating for these impairments in post-stroke depression interventions may potentially enhance therapeutic outcomes.</p>","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-11"},"PeriodicalIF":2.5000,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Specific within-domain cognitive impairments predict depression severity six-months after stroke.\",\"authors\":\"Kyle Kelleher, Nele Demeyere, Andrea Kusec\",\"doi\":\"10.1080/10749357.2025.2557317\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Following stroke, chronic cognitive impairments across multiple domains have been associated with depression. Currently, it is unknown if specific subtypes of cognitive impairments are differentially related to post-stroke depression severity.</p><p><strong>Objectives: </strong>To explore the differential associations between within-domain cognitive impairment to depression severity six-months after stroke.</p><p><strong>Methods: </strong>Participants (<i>n</i> = 385, Age <i>M</i> = 73.86 years [<i>SD</i> = 12.51], National Institutes of Health Stroke Severity <i>M</i> = 6.83 [<i>SD</i> = 6.01]) were recruited from an acute stroke ward. Participants completed a self-report mood measure (Hospital Anxiety and Depression Scale; HADS) and a stroke-specific cognitive assessment (Oxford Cognitive Screen; OCS). Separate multiple regressions predicting depression were conducted across 1) OCS domain-specific cognitive impairments of language, memory, attention, praxis, numeracy, and executive function, and 2) the novel subtask-specific impairments within each OCS domain. Anxiety severity and years of education attained were included as covariates.</p><p><strong>Results: </strong>Within-domain impairments that were uniquely associated with depression severity were calculation (<i>b</i><sub>(.57)</sub> = 1.44, 95% <i>CI</i> [0.31, 2.56], <i>p</i> = .012), episodic memory (<i>b</i><sub>(.52)</sub> = 1.36, 95% <i>CI</i> [0.34, 2.37], <i>p</i> = .009), picture naming (<i>b</i><sub>(.45)</sub> = 1.18, 95% <i>CI</i> [0.31, 2.06], <i>p</i> = .008), number writing (<i>b</i><sub>(.46)</sub> = 2.54, 95% <i>CI</i> [0.26, 2.07], <i>p</i> = .012), and visuospatial attention (<i>b</i><sub>(.35)</sub> = 1.24, 95% <i>CI</i> [0.54, 1.93], <i>p</i> = .001). Analysis in pooled multiply imputed data (<i>N</i> = 430) corroborated complete case analysis findings.</p><p><strong>Conclusions: </strong>Specific within-domain cognitive impairments have differential relationships with post-stroke depressive symptomology. Accommodating for these impairments in post-stroke depression interventions may potentially enhance therapeutic outcomes.</p>\",\"PeriodicalId\":23164,\"journal\":{\"name\":\"Topics in Stroke Rehabilitation\",\"volume\":\" \",\"pages\":\"1-11\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Topics in Stroke Rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/10749357.2025.2557317\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Topics in Stroke Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10749357.2025.2557317","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
摘要
背景：中风后，多个领域的慢性认知障碍与抑郁症有关。目前，尚不清楚特定亚型的认知障碍是否与脑卒中后抑郁严重程度存在差异。目的：探讨脑卒中后6个月域内认知障碍与抑郁严重程度之间的差异关系。方法：从急性脑卒中病房招募参与者（n = 385，年龄M = 73.86岁[SD = 12.51]，美国国立卫生研究院卒中严重程度M = 6.83 [SD = 6.01]）。参与者完成了自我报告情绪测量（医院焦虑和抑郁量表；HADS）和中风特异性认知评估（牛津认知屏幕；OCS）。分别对OCS区域的语言、记忆、注意、实践、计算和执行功能的认知障碍和每个OCS区域的新子任务特异性障碍进行了预测抑郁的多元回归。焦虑严重程度和受教育年限被纳入协变量。结果：计算了与抑郁严重程度唯一相关的域内损伤(b(.57) = 1.44, 95% CI [0.31, 2.56], p =。012),情景记忆(b(点)= 1.36,95%可信区间[0.34,2.37],p =。009),图片命名(b(.45) = 1.18, 95%可信区间[0.31,2.06],p =。008),写(b (.46) = 2.54, 95% CI [0.26, 2.07], p =。012)和视觉空间注意力（b(.35) = 1.24, 95% CI [0.54, 1.93], p = .001）。合并多重输入数据（N = 430）的分析证实了完整的病例分析结果。结论：特定的领域内认知障碍与脑卒中后抑郁症状有不同的关系。在卒中后抑郁干预中适应这些损伤可能会潜在地提高治疗效果。
Specific within-domain cognitive impairments predict depression severity six-months after stroke.
Background: Following stroke, chronic cognitive impairments across multiple domains have been associated with depression. Currently, it is unknown if specific subtypes of cognitive impairments are differentially related to post-stroke depression severity.
Objectives: To explore the differential associations between within-domain cognitive impairment to depression severity six-months after stroke.
Methods: Participants (n = 385, Age M = 73.86 years [SD = 12.51], National Institutes of Health Stroke Severity M = 6.83 [SD = 6.01]) were recruited from an acute stroke ward. Participants completed a self-report mood measure (Hospital Anxiety and Depression Scale; HADS) and a stroke-specific cognitive assessment (Oxford Cognitive Screen; OCS). Separate multiple regressions predicting depression were conducted across 1) OCS domain-specific cognitive impairments of language, memory, attention, praxis, numeracy, and executive function, and 2) the novel subtask-specific impairments within each OCS domain. Anxiety severity and years of education attained were included as covariates.
Results: Within-domain impairments that were uniquely associated with depression severity were calculation (b(.57) = 1.44, 95% CI [0.31, 2.56], p = .012), episodic memory (b(.52) = 1.36, 95% CI [0.34, 2.37], p = .009), picture naming (b(.45) = 1.18, 95% CI [0.31, 2.06], p = .008), number writing (b(.46) = 2.54, 95% CI [0.26, 2.07], p = .012), and visuospatial attention (b(.35) = 1.24, 95% CI [0.54, 1.93], p = .001). Analysis in pooled multiply imputed data (N = 430) corroborated complete case analysis findings.
Conclusions: Specific within-domain cognitive impairments have differential relationships with post-stroke depressive symptomology. Accommodating for these impairments in post-stroke depression interventions may potentially enhance therapeutic outcomes.
期刊介绍：
Topics in Stroke Rehabilitation is the leading journal devoted to the study and dissemination of interdisciplinary, evidence-based, clinical information related to stroke rehabilitation. The journal’s scope covers physical medicine and rehabilitation, neurology, neurorehabilitation, neural engineering and therapeutics, neuropsychology and cognition, optimization of the rehabilitation system, robotics and biomechanics, pain management, nursing, physical therapy, cardiopulmonary fitness, mobility, occupational therapy, speech pathology and communication. There is a particular focus on stroke recovery, improving rehabilitation outcomes, quality of life, activities of daily living, motor control, family and care givers, and community issues.
The journal reviews and reports clinical practices, clinical trials, state-of-the-art concepts, and new developments in stroke research and patient care. Both primary research papers, reviews of existing literature, and invited editorials, are included. Sharply-focused, single-issue topics, and the latest in clinical research, provide in-depth knowledge.
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