Anxiety Strongly Linked to Cognitive Impairment After Hemorrhagic Stroke: Study
Anxiety has been found to have a significant association with cognitive impairment at three months after hemorrhagic stroke, according to a new study published in The Journal of Neuropsychiatry and Clinical Neurosciences. The finding points out the psychological and cognitive burden faced by patients recovering from intracerebral hemorrhage (ICH) or subarachnoid hemorrhage (SAH) and underlines the use of integrated neuropsychiatric rehabilitation in post-stroke care. The study was conducted by Sammi Z. and colleagues.
Although physical recovery remains a major focus of stroke rehabilitation, cognitive deficits and psychiatric issues, including anxiety, depression, and sleep disturbance, are increasingly recognized as critical determinants of long-term recovery and independence. This study aimed to assess the relationships among cognitive impairment, psychiatric symptoms, and functional status three months after hospital discharge.
The study included 101 patients who suffered from nontraumatic ICH (N=62) or SAH (N=39). Follow-up for all patients was performed three months after their discharge through telephone assessments. Neuropsychiatric outcomes were measured using the Neuro-QoL cognitive function, anxiety, depression, and sleep disturbance short forms. Functional recovery was assessed by the mRS, a standard tool for describing the degree of disability after stroke. Patients were classified based on cognitive performance into those with poor cognition using the Neuro-QoL T score ≤ 50. The study then analyzed the relationships between poor cognition, functional outcomes, and psychiatric symptoms in both the overall hemorrhagic stroke group (ICH + SAH) and the ICH subgroup alone.
Key Findings
The results showed remarkably high rates of post-stroke cognitive and emotional impairment:
51% of patients had poor cognition three months after the hemorrhage.
61% demonstrated functional dependence, as represented by mRS scores of 3–5, which indicate moderate to severe disability.
Anxiety was reported by 43%, depression by 28%, and sleep disturbance by 31%.
In the univariate analysis of the entire cohort, poor cognition was significantly associated with:
Anxiety, depression, sleep disturbance, and mRS scores of 3–5, p < 0.05.
However, multivariate analysis refined these relationships to show two key associations:
Anxiety (OR = 4.38, 95% CI = 1.30–14.74, p = 0.017)
Functional disability (mRS 3–5) (OR = 6.15, 95% CI = 1.96–19.32, p = 0.002)
In the analysis of only patients with ICH (N=62), univariate analyses showed that poor cognition was associated with anxiety, sleep disturbance, and mRS 3–5 (p < 0.05).
In this subgroup, multivariate analysis confirmed anxiety as a strong independent predictor of cognitive impairment, with OR = 10.98 (95% CI = 2.32–51.99, p = 0.003).
The findings emphasize that the management of anxiety is a priority in post-stroke care and may be important not only for alleviating emotional distress but possibly for improving cognitive recovery. This suggests that future studies are required to confirm whether treatment of anxiety can lead to a direct improvement in cognitive outcomes in this population, leading to the development of more holistic and effective strategies in stroke rehabilitation.
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