Correlates and predictors of apathy, depression and fatigue post-stroke

Stroke is a leading cause of disability in the UK and has a range of psychological sequelae including apathy, depression and fatigue. Psychological consequences of stroke have been associated with poor rehabilitation outcomes. Apathy, depression and fatigue are often considered to overlap and the research indicates that they may occur both independently and in unison after stroke.
Sixty-three people aged over 55 years who had a stroke and lived in the community were included in this study. They were assessed using the Apathy Evaluation Scale, Geriatric Depression Scale, the Fatigue Severity Scale and the Barthel index. Socio-demographic data were also collected along with information about their stroke.
60.3% of participants reached cut-off levels for apathy, 58.6% for depression and 58.7% for fatigue. While there was an overlap in terms of these psychological disorders, they also occurred independently. Physical functioning was the only factor which was related to apathy, depression and fatigue. Apathy was a mediator in the relationship between physical functioning and depression; and depression was a mediator in the relationship between apathy and fatigue. Based on these findings, a significant structural equation model accounting for the relationships between apathy, fatigue, physical functioning and depression was developed.
The study concluded that apathy, depression and fatigue are common post-stroke. The inter-relationships between these post-stroke sequelae are also related to the person’s physical functioning and not to age, side of weakness or time since stroke. Results have implications in terms of the clinical assessment and management of post-stroke psychological sequelae.