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Prevalence, predictors, and prognoses of prestroke neuropsychiatric symptoms at 3 months poststroke

Published online by Cambridge University Press:  30 December 2020

Akin Ojagbemi ,
Toyin Bello ,
Mayowa Owolabi  and
Olusegun Baiyewu
Akin Ojagbemi
Affiliation:
Department of Psychiatry, World Health Organization (WHO) Collaborating Centre for Research and Training in Mental health, Neuroscience, and Substance Abuse, College of Medicine, University of Ibadan, Ibadan, Nigeria Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
Toyin Bello
Affiliation:
Department of Psychiatry, World Health Organization (WHO) Collaborating Centre for Research and Training in Mental health, Neuroscience, and Substance Abuse, College of Medicine, University of Ibadan, Ibadan, Nigeria
Mayowa Owolabi
Affiliation:
Division of Neurology, Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
Olusegun Baiyewu*
Affiliation:
Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
*
Correspondence should be addressed to: Olusegun Baiyewu, Department of Psychiatry, College of Medicine, University of Ibadan, P.M.B 5017 (G.P.O), Ibadan, Nigeria. Phone: +2348036737171; Fax: 346546. Email: olusegun_baiyewu@yahoo.com.
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Abstract

Objectives:

Prior neuropsychiatric disturbances are risk factors for stroke. There is a knowledge gap on the predictors of prestroke psychopathology, as well as their association with stroke outcomes in survivors living in low- and middle-income countries (LMICs). We estimated prevalence, predictors, and association of prestroke neuropsychiatric symptoms with poststroke depression (PSD), disability, and mortality.

Design:

Prospective observation.

Setting:

Nigeria.

Participants:

Adult ischemic and hemorrhagic stroke survivors.

Measurements:

Prestroke psychopathology were ascertained using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Outcomes were assessed using validated tools, including the Centre for Epidemiologic Studies – Depression Scale (CES-D 10) and modified Rankin scale (mRS). Independent associations were investigated using regression models with Bonferroni corrections, and presented as standardized mean differences (SMD) and odds ratios (OR) within 95% confidence intervals (CI).

Results:

Among 150 participants, prestroke neuropsychiatric symptoms were found in 78 (52%). In multivariate logistic regression analyses, prestroke sleep disturbance was associated with systemic hypertension (OR = 5.39, 95% CI = 1.70–17.08). Prestroke neuropsychiatric symptoms independently predicted worse motor disability scores (SMD = 0.92, 95% CI = 0.21–1.62) and greater odds of poststroke mortality (OR = 2.7, 95% CI = 1.1–7.0) at 3 months. However, prestroke depression was not significantly associated with PSD.

Conclusion:

Prestroke sleep disturbances was associated with systemic hypertension, a key index of high cardiovascular risk profile and stroke. The findings should energize before-the-stroke identification and prioritization of limited treatment resources in LMICs to persons with sleep symptoms who have multiple, additional, risks of stroke.

Keywords

stroke burdenstroke risk factorsmental health complicationsprestroke symptomssub-Saharan Africa
Type
Original Research Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 8: Issue Theme: Longitudinal Studies of Aging , August 2021 , pp. 827 - 834
Copyright
© International Psychogeriatric Association 2020

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