Prevalence of poststroke anxiety and its associations with global cognitive impairment: An individual participant data analysis

Background and purpose: Anxiety is frequent after stroke; however, little is known about its determinants. This study aims to assess the prevalence and correlates of post stroke anxiety (PSA) within 3–6 months following ischemic stroke. Methods: Three cohort studies from the STROKOG consortium were involved. Demographic and clinical data were standardized. PSA and PSD were assessed using inventories. The criteria for post-stroke cognitive impairment (PSCI) were at least one cognitive domain impaired if applicable, or a Montreal Cognitive Assessment (MoCA) score. Descriptive analyses were conducted to ascertain the prevalence of anxiety. Comparisons between anxious and non-anxious patients in the total sample were made using χ ² and t-tests. A two-step individual participant data (IPD) meta-analysis was employed to identify factors associated with PSA. Results: 584 patients were included. The total prevalence of PSA was 35 % (95%CI = [31.23;38.97]) and ranged from 27 % to 45 % across cohorts. In the total sample, there was a higher proportion of females in the anxiety group than the non-anxiety group (χ ² = 19.62; p < 0.001). Anxious patients had lower education, (χ ² = 6.59; p = 0.03), higher stroke severity (t = 2.77; p = 0.002), and higher rates of PSD (χ ² = 118.09; p < 0.001), and PSCI (χ ² = 23.81, p < 0.001). The analysis demonstrates that the odds of presenting with PSA is larger in patients with PSCI (OR = 1.84, 95%CI = [1.14; 2.91]). Conclusions: Anxiety is frequent after stroke, especially in females, and is associated with depression and cognitive impairment.