关键词: 卒中, 抑郁, 运动活动, 信息交流, 影响因素分析

Abstract: Objective　To analyze the influence of fitness activities，social interactions and brain habits on the depressive symptoms of elderly patients with newly diagnosed ischemic stroke.Methods　A total of 916 elderly patients with first-onset ischemic stroke who were treated in the Department of Neurology of the Affiliated Hospital of Jining Medical University between June 2016 and July 2017 and met the inclusion criteria were selected as study subjects.Three months after the onset of the disease，a questionnaire survey was conducted by trained neurosurgical staff.The items in the questionnaire comprised general information including sex，age，ethnicity，marital status，education level，participation in fitness activities（intensive，moderate and leisure fitness activities），social activities（communication frequency with families and friends） and brain habits（reading and playing chess），geriatric depression scale（GDS-15） score，lesion locations（stroke lesion in the left/right or anterior/posterior，as well as specific stroke sites），and NIH stroke scale（NIHSS） score.Univariate and multivariate Logistic regression were used to analyze factors influencing the depression symptoms in elderly patients with newly diagnosed ischemic stroke.Results　A total of 916 questionnaires were distributed，and 764 valid questionnaires were collected.The effective recovery rate was 83.4%.Of the 764 stroke patients，70（9.2%） had depressive symptoms，and 694（90.8%） had no depressive symptoms.Univariate Logistic regression analysis showed that mild leisure fitness activities〔OR=0.451，95%CI（0.253，0.805）〕，the frequency of interaction with families or friends〔OR=0.176，95%CI（0.103，0.301）〕，the stroke position（anterior/posterior）〔OR=2.359，95%CI（1.510，3.562）〕，and the NIHSS score〔OR=1.817，95%CI（1.166，3.358）〕 were the factors associated with depressive symptoms in elderly patients with ischemic stroke（P<0.05）．Multivariate Logistic regression analysis showed that mild leisure fitness activities〔OR=0.503，95%CI（0.277，0.915）〕，the frequency of interaction with families or friends〔OR=0.189，95%CI（0.110，0.326）〕，the stroke position（anterior/posterior）〔OR=2.487，95%CI（1.497，4.134）〕，and the NIHSS score〔OR=1.901，95%CI（1.154，3.130）〕 were the factors associated with depressive symptoms in elderly patients with ischemic stroke（P<0.05）．Conclusion　Participating in mild leisure fitness activities and communicating with friends are protective factors against depressive symptoms in elderly patients with newly diagnosed ischemic stroke.Stroke in the anterior brain and an NIHSS score ≥5 are the risk factors for depression in elderly patients with newly diagnosed ischemic stroke.The relationship between brain habits and depressive symptoms was not significant in the population.

Key words: Stroke, Depression, Motor activity, Communication, Root cause analysis