Specific Within-Domain Cognitive Impairments Predict Depression Severity Six-Months After Stroke

BackgroundFollowing stroke, chronic cognitive impairments across multiple domains have been associated with depression. Currently, it is unknown if specific subtypes of cognitive impairments differentially relate to post-stroke depression severity. This study aimed to explore the differential associations between within-domain cognitive impairment to depression severity six-months after stroke. MethodParticipants (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. ResultsWithin-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. ConclusionsSpecific 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.