Prevalence and severity of depression, anxiety, and cognitive impairment in acute ischemic stroke patients: a cross-sectional study

Abstract

Introduction. Post-stroke depression (PSD) and anxiety are common neuropsychiatric sequelae of stroke, occurring in roughly one-third of survivors. Cognitive impairment is also frequently observed, affecting up to half of stroke patients. These conditions adversely impact rehabilitation and quality of life. This study aimed to determine the prevalence and severity of depression, anxiety, and cognitive deficits in patients with acute ischemic stroke. Material and methods. We conducted an observational study involving 99 patients with acute ischemic stroke, assessed within approximately two weeks of symptom onset, who were admitted to a tertiary care unit. Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales, supplemented by the clinician-rated Hamilton Depression (HAM-D) and Anxiety (HAM-A) scales. Cognitive status was evaluated with the Mini-Mental State Examination (MMSE). Descriptive statistics (proportions, means ± SD) were used to summarize the prevalence and severity of each condition. Results. The cohort had a mean age of 64.8 ± 8.1 years and was 63.5% male. Vascular risk factors were prevalent, with 88% of patients having hypertension and 33% having diabetes. Based on patient-reported measures, 16% of patients exhibited moderate depressive symptoms (PHQ-9 ≥10), while 42% reported moderate to severe anxiety (GAD-7 ≥10). Clinician- administered assessments identified 35% of patients with moderate to severe depression (HAM-D ≥17) and 35% with clinically significant anxiety (HAM-A ≥18). The vast majority of patients (~92%) reported at least mild depressive symptoms, although only 0–1% met the criteria for severe depression. Conclusions. Depression, anxiety, and cognitive deficits are highly prevalent in the acute phase of ischemic stroke, with approximately one in three patients experiencing clinically significant depression or anxiety and one in four exhibiting cognitive impairment. These findings underscore the importance of early neuropsychological assessment and intervention as part of acute stroke care to improve rehabilitation outcomes.