Identifying key predictors of post-stroke depression and cognitive impairment in acute stroke survivors
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By
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Zhiwen Yan
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Huan Zhao
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Jianjun Chen
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Fang Liu
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Lei Gong
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Yingli Li
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Jie Zhang
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Mi Xiao
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Jun Mu
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May 20, 2026
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Clinical Scorecard: Determining Major Predictors of Depression and Cognitive Decline Following Acute Stroke in Survivors
At a Glance
| Category | Detail |
|---|
| Condition | Post-stroke depression (PSD) and post-stroke cognitive impairment (PSCI) |
| Key Mechanisms | Right hemisphere lesions, emotional distress, cognitive vulnerability |
| Target Population | Acute stroke survivors |
| Care Setting | Neurology department, acute care setting |
Key Highlights
- 71.8% of stroke survivors developed PSD and/or PSCI within 6 months
- Independent predictors include right hemisphere lesions, higher PHQ-9 scores, and lower MMSE scores
- Emotional distress and cognitive vulnerability are critical for early risk stratification
Guideline-Based Recommendations
Diagnosis
- Utilize DSM-5 and NINDS-CSN criteria for diagnosing PSD and PSCI
Management
- Implement early psychological triage and integrated cognitive-emotional monitoring
Monitoring & Follow-up
- Regular assessment of PHQ-9 and MMSE scores to track emotional and cognitive status
Risks
- Increased risk of PSD and PSCI associated with right hemisphere lesions and baseline emotional distress
Patient & Prescribing Data
Acute ischemic stroke survivors, median age 62 years
Focus on early identification and intervention to improve long-term outcomes
Clinical Best Practices
- Conduct comprehensive neuropsychological evaluations within the acute phase
- Monitor biochemical indicators alongside clinical assessments for better risk stratification
- Encourage multidisciplinary approaches for managing PSD and PSCI
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