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Life before and after Stroke: Living Conditions and Life Satisfaction in Relation to a General Elderly Population
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.ORCID iD: 0000-0002-8114-7615
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
Umeå University, Faculty of Social Sciences, Department of Sociology. (Department of Social Welfare, University of Umeå, Sweden)
1992 (English)In: Cerebrovascular Diseases, ISSN 1015-9770, E-ISSN 1421-9786, Vol. 2, no 1, 28-34 p.Article in journal (Refereed) Published
Abstract [en]

Living conditions and life satisfaction before and after stroke were assessed in 80 patients with acute stroke (mean age 73 years). The results were compared with a general elderly population. Already prior to their stroke the patients had more health problems, lower functional ability, more passive leisure time and lower global life satisfaction. Low life satisfaction was associated with dependence in the activities of daily living (ADL). Economic resources, social network and psychiatric morbidity before stroke did not differ from the general elderly population. At 3 months of follow-up, almost half of the patients reported low life satisfaction, compared to only 2% in the national sample. Major depression and ADL dependence were associated with low life satisfaction after stroke. We conclude that much of the disability and handicap seen in stroke patients is present already before the stroke. Stroke-related deterioration of ADL performance, major depression and social disintegration after stroke interact to further reduce life satisfaction for the stroke victims and their families.

Place, publisher, year, edition, pages
S. Karger, 1992. Vol. 2, no 1, 28-34 p.
National Category
Sociology Psychiatry
URN: urn:nbn:se:umu:diva-99080DOI: 10.1159/000108984OAI: diva2:785848
Available from: 2015-02-04 Created: 2015-02-03 Last updated: 2015-12-07
In thesis
1. Depression after stroke
Open this publication in new window or tab >>Depression after stroke
1993 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Both stroke and depression are major health problems in the elderly. In this study, the prevalence of major depression after stroke was investigated in a well-defined sample of acute stroke patients (n=80), followed up at 3 months, 1 year, 2 and 3 years after the stroke event. Links to biological and psychosocial factors were examined. Hypercortisolism was studied by the dexamethasone suppression test and compared with healthy elderly. Living conditions (including demographic caracteristics, economic resources, health, functional ability, activity/leisure, social network) and life satisfaction were described before and after stroke in relation to a general elderly population.

Demographic caracteristics, economic resources, social network and psychiatric morbidity prestroke did not differ from the general elderly population. Already prior to the stroke, patients reported more health problems and lower functional ability in many aspects of daily life, more passive leisure time and a lower global life satisfaction. After stroke, contacts with children were maintained, whilst contacts outside the family declined and remained lower than in the general elderly population. Stroke involved a marked reduction in global life satisfaction. Poor life satisfaction at 1 year remained poor for the entire three years; these stroke victims had a higher frequency of major depression early after stroke.

The prevalence of major depression was 25% at the acute stage, 31% at 3 months, decreased to 16% at 1 year, was 19% at 2 years and increased to 29% at 3 years. The most important predictors of immediate major depression were left anterior brain lesion, dysphasia, and living alone. Dependence in self-care ability and loss of social contacts outside the family were the most important predictors at 3 months. From 1 year onwards, loss of social contacts contributed most to depression and at 3 years also cerebral atrophy. Sixty percent of patients with early depression (0-3 months) had recovered at 1 year; those not recovered at 1 year had a high risk of chronicitation.

Hypercortisolism as measured by the dexamethasone suppression test was associated with major depression late (3 years) but not early (0-3 months) after stroke. At 3 years, the dexamethasone suppression test had a sensitivity of 70%, a specificity of 97%, a positive predictive value of 88%, a negative predicitive value of 91%, and a diagnostic accuracy of 90%. Nonsuppression of dexamethasone at 3 months was a significant predictor of major depression at 3 years.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 1993. 63 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 364
Cerebrovascular disorders, stroke, depression, living conditions, life satisfaction, social network, dysphasia, self-care ability, cerebral atrophy, dexamethasone
National Category
Medical and Health Sciences Psychiatry
urn:nbn:se:umu:diva-96912 (URN)91-7174-768-0 (ISBN)
Public defence
1993-04-23, Aulan, Administrationsbyggnaden, BV, Norrlands Universitetssjukhus, Umeå universitet, Umeå, 10:00

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Available from: 2015-02-03 Created: 2014-12-05 Last updated: 2015-04-10Bibliographically approved

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Åström, MonicaAdolfsson, RolfAsplund, Kjell
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