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Depression and cognitive impairment after stroke: expanded evaluation in the study of stroke mortality and morbidity (EMMA), São Paulo-Brazil


Poststroke patients can often develop neuropsychological changes as depressive symptoms and cognitive impairment that may progress to severe depression and dementia. It is estimated that depression after stroke may occur in approximately 30-50% of cases and usually is associated with worse cognitive status, impaired motor function recovery and increased mortality. We propose an ancillary study linked to a stroke prospective cohort, the Study of Morbidity and Mortality of Stroke (EMMA) for assessment of poststroke depression and cognitive impairment during 1-year of follow-up. Methodology: Consecutive patients, who were admitted in the Hospital Universitário of the University of São Paulo with confirmed stroke diagnosis and were included in the EMMA study, will followed at 28 days, 180 days and 1 year. At 28 days, all participants will undergo magnetic resonance imaging for evaluation of neurologic symptoms, and also will be interviewed on specific batteries for depression (Structured Clinical Interview for DSM-4 - SCID-I, Patient Health Questionnaire - PHQ-9, Hamilton Depression Rate Scale - HDRS-31); rating scales of cognitive state (Telephone Interview Cognitive Status - TICS-M, Mini-Mental State Examination - MMSE, Montreal Cognitive Assessment - MoCA), and evaluation of quality of life (Stroke Scale Quality of Life - SSQOL, Short Term Form - SF-36). At the 180-day and 1-year follow-up,a telephone interview will performed using the scales PHQ-9 and TICS-M and SSQOL. Expected Results: We believe that this project will corroborate for investigation of risk factors most relevant to the development of depressive symptoms and cognitive impairment after stroke. (AU)

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