Association between Economic Status and Post-stroke Depression in Middle and Older Age: Results from China Health and Retirement Longitudinal Study (CHARLS)

Abstract

Abstract Introduction: Post-stroke depression (PSD) is a common neuropsychiatric complication that affects approximately one-third of stroke patients. The prognosis and treatment of this disease are poor.There have been many studies exploring PSD risk factors, but previous studies have rarely focused on economic conditions and have not explored the role of urban-rural differences in PSD. Given the substantial population of stroke patients in China, it is crucial to examine the potential risk factors, including economic factors, contributing to PSD. By conducting studies on this population and investigating the influence of economic conditions, we can gain valuable theoretical insights to guide PSD prevention and management. Methods: We utilized data from the 2018 CHARLS and selected appropriate samples for analysis. Depressive symptoms were assessed using the CES-D 10 scale, a validated tool for measuring depressive symptoms in the general population. Multiple logistic regression analysis was employed to assess the association between economic status and post-stroke depression and evaluate any urban-rural differences. Results: Of the 1009 respondents in the study, 446 (44.2%) had depression. After adjusting for all covariates, we found that in the urban sample, participants with more health insurance cases had a lower risk of PSD (OR=0.19, 95% CI: 0.04-0.85, P=0.03). Conversely, in the rural sample, a significant correlation was reported between individual annual income and PSD occurrence (OR=0.19, 95% CI: 0.05-0.73, P=0.02). Conclusions: Self-reported health status, number of other disabilities, night sleep duration, ADL, and life satisfaction also influenced PSD. The research results confirm that the increase of incidence rate of post-stroke depression (PSD) is related to many factors. Higher prevalence rates were observed in individuals with poorer economic conditions. This connection is particularly evident when comparing urban and rural areas. By addressing these factors and improving the economic situation, we can reduce the prevalence of PSD and strengthen comprehensive management of this situation.