Association between post-stroke psychological disorders, activity limitations and health-related quality of life in chronic stroke survivors in Benin

Abstract

Purpose

To evaluate the association between depression/anxiety and activity limitations and health-related quality of life (HRQoL) in chronic stroke survivors in Benin.

Materials and methods

One hundred and seventy-six chronic stroke survivors (113 males; mean age (±SD): 56.5 (±10.5) years old) were included. We used the Barthel index (BI) to assess activity limitations. Participants were screened for depression and anxiety symptoms using Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HARS). Euroqol-5 Dimensions-3 Levels (EQ-5D-3L) including a Visual Analog Scale (EQ-VAS) was used to assess HRQoL. Multivariate linear regressions were performed to determine the impact of psychological disorders on activity limitations and HRQoL.

Results

Depression (β=–0.54; p < 0.0001) and anxiety (β=–0.35; p < 0.0001) were negatively associated with activity limitations (R²=0.60). Similar patterns of association were observed with HRQoL (β≤–0.28; p < 0.0001; R² ≥0.40). Inversely, occupational status showed positive association with EQ-5D-3L summary index scores (β = 0.21; p = 0.015).

Conclusions

Depression and anxiety had a negative impact on activity limitations and HRQoL in Beninese chronic stroke survivors. This call for action to integrate psychological interventions as part of rehabilitation programs in low and middle-income countries.

Implications for rehabilitation

• Post-stroke depression and anxiety are quite common among stroke survivors in sub-Saharan Africa.

• Post-stroke depression and anxiety negatively impact activities and health-related quality of life in chronic stroke survivors in sub-Saharan Africa.

• Managing these post-stroke psychological disorders is necessary to promote the functional recovery and social reintegration of stroke survivors in their communities.

Keywords:

• Stroke survivors
• activity limitations
• depression
• anxiety
• health-related quality of life

Acknowledgements

The authors thank the hospital staff who facilitated the data collection and all stroke survivors who participated in this study.

Author contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by Fatimata Ouédraogo, Orthelo Léonel G. Atigossou, Aristide S. Honado, and Charles S. Batcho. The first draft of the manuscript was written by Orthelo Léonel G. Atigossou and Charles S. Batcho. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).