Gender Differences in the Prevalence and Correlates of Post-Stroke Depression among Older Stroke Survivors: Findings from a National Survey in China.

BACKGROUND:Post-stroke depression (PSD) is a common neuropsychiatric complication in stroke survivors. However, gender differences in the prevalence and correlates of PSD are underexplored. This study examined gender differences in PSD prevalence and their demographic and clinical correlates among older stroke survivors. METHODS:Data from a large national survey conducted in China during 2017-2018 were analyzed. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale. Univariate and multivariate analyses examined the demographic and clinical correlates of PSD by gender. RESULTS:A total of 1123 older stroke survivors (65 years of age or above), including 578 males (51.5%) and 545 females (48.5%), were included. The overall PSD prevalence was 34.28% (95% CI = 31.52%-37.15%), with significantly higher prevalence in females (38.71%; 95% CI: 34.62%-42.96%) compared to males (30.10%; 95% CI: 26.42%-34.05%). In males, engaging in recent physical exercise (OR: 0.604; 95% CI: 0.389-0.936; p = 0.024) was associated with a lower PSD risk, while more activity limitations (OR: 1.727; 95% CI: 1.131-2.639; p = 0.011) and severe anxiety (OR: 1.455; 95% CI: 1.334-1.586; p < 0.001) were associated with higher risk. In females, recent physical exercise (OR: 0.370; 95% CI: 0.235-0.581; p < 0.001) was linked to lower PSD risk, while heart disease (OR: 1.698; 95% CI: 1.136-2.539; p = 0.010) and severe anxiety (OR: 1.516; 95% CI: 1.372-1.674; p < 0.001) were associated with higher risk. CONCLUSION:This study highlights the gender differences in PSD prevalence and correlates among older Chinese stroke survivors. Tailored interventions are needed to address PSD, with future research focusing on targeted screening and intervention.