The Impact of Post-stroke Depression and Physical Fatigue on Functional Status

Abstract

Background: Stroke is a leading cause of long-term disability globally, with post-stroke depression and physical fatigue recognized as prominent complications affecting recovery and rehabilitation. This study aims to comprehensively investigate the impact of post-stroke depression and physical fatigue on the functional outcomes of individuals who have experienced stroke.

Methods: This research involved a retrospective analysis of clinical data from patients with stroke admitted to Taihe County People's Hospital between January 2022 and May 2023. Patients were categorized into two groups based on their prognostic functional status: good and poor. The impact of post-stroke depression and physical fatigue on functional outcomes was assessed using standardized assessment tools. Specifically, the Patient Health Questionnaire-9 (PHQ-9) was employed to measure depression severity, while the Fatigue Severity Scale (FSS) was utilized to quantify physical fatigue.

Results: Post-stroke depression and physical fatigue were significantly associated with functional status. The post-stroke depression scores were notably higher in the poor functional status group (10.58 ± 3.82) compared to the good functional status group (7.81 ± 2.12) (t = 4.482, p < 0.001). Similarly, post-stroke physical fatigue scores were significantly elevated in the poor functional status group (56.87 ± 2.53) compared to the good functional status group (43.26 ± 1.58) (t = 32.264, p < 0.001). Correlation analysis revealed a minimal correlation between depression scores and functional status (rho = 0.043, p = 0.674) after 3 months, as well as between physical fatigue scores and functional status (rho = –0.168, p = 0.094). At the six-month follow-up, a statistically significant correlation was observed between depression scores and functional status (rho = 0.398, p < 0.001). Moreover, a strong and significant correlation was identified between physical fatigue scores and functional status (rho = 0.761, p < 0.001). Multivariate logistic regression analysis revealed that at three months post-stroke, depression did not significantly affect functional status (odds ratio (OR) = 3.328, p = 0.079). However, at six months post-stroke, depression demonstrated a statistically significant effect (OR = 1.436, p = 0.030). Physical fatigue showed no significant impact on functional status at three months (OR = 1.010, p = 0.927), whereas at six months, it showed a statistically significant effect (OR = 1.581, p < 0.001).

Conclusions: These findings underscore the critical importance of integrated care models and early intervention strategies addressing post-stroke depression and physical fatigue to optimize functional outcomes and enhance the overall quality of life for stroke survivors.