Post-stroke Depression, Functional Independence, and Cognition Among Patients With High Social Support in Georgia: A Cross-Sectional Study

乔治亚州高社会支持人群中风后抑郁、功能独立性和认知能力:一项横断面研究

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Abstract

OBJECTIVES: The study aims to assess the relationships between depressive symptoms and functional as well as cognitive outcomes in Georgian stroke patients who report a high perception of social support (SS). METHODS:  A cross-sectional analysis was conducted between September and December 2024 at the Ken Walker Hospital and Aversi Rehabilitation Center. A total of 33 post-stroke patients with a high perception of social support as measured by the Multidimensional Scale of Perceived Social Support (MSPSS) were selected and assessed for depression using the Patient Health Questionnaire-9 (PHQ-9). Cognitive function and functional independence scores were obtained from the respective institutions' medical databases. Spearman's correlation and multivariate linear regression were used for data analysis. RESULTS: Functional independence showed a strong inverse correlation with depressive symptoms (r = -0.69, p < 0.001), and cognitive performance correlated moderately and inversely with depression severity (r = -0.52, p = 0.008) in patients with a high perception of social support. Regression analysis, when controlled for age and sex, showed that higher PHQ-9 scores were significantly associated with lower Barthel Index (β = -0.1987, p =0.001) and MoCA scores (β = -1.0589, p = 0.004), supporting findings from bivariate analyses. CONCLUSIONS:  High perception of social support did not appear to "buffer" the association between post-stroke depression (PSD) and poor functional or cognitive outcomes, particularly within the sociocultural context of the country of Georgia. This cultural context of strong familial support and traditional societal roles is particularly understudied and is similar to those seen in several other Eastern European/Asian countries. Larger longitudinal studies are needed to clarify causal pathways and eliminate all possible confounders.

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