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Mental health was measured with Patient Health Questionnaire-4, and health-related quality of life was evaluated using the EuroQol 5-dimension 5-level scale. Latent profile analysis identified subgroups, and mediation analysis explored mental health's role.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three subgroups were identified: Mild (65.4%,\n                      <jats:italic toggle=\"yes\">n\u2009=\u2009<\/jats:italic>\n                      365), Moderate (17.4%,\n                      <jats:italic toggle=\"yes\">n\u2009=\u2009<\/jats:italic>\n                      97), and Severe (17.2%,\n                      <jats:italic toggle=\"yes\">n\u2009=\u2009<\/jats:italic>\n                      96). Mediation analysis showed that, compared with the Mild subgroup, survivors in the Moderate subgroup (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      \u2009=\u20090.138, 95% CI: 0.055 to 0.232) and the Severe subgroup (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      \u2009=\u20090.217, 95% CI: 0.113 to 0.316) exhibited worse mental health, and poorer mental health was associated with lower health-related quality of life (\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.119, 95% CI: \u22120.170 to \u22120.075).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study suggests heterogeneity in multiple-adverse health conditions and indicates that mental health may partially account for the association between these conditions and health-related quality of life in stroke survivors. The findings highlight the need for further research into subgroup-specific interventions\u2014with particular attention to mental health\u2014to determine whether such approaches could improve health-related quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692155261478022","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T13:01:51Z","timestamp":1786626111000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multiple-adverse health conditions, mental health, and health-related quality of life in stroke survivors: Latent profile analysis and mediation analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5699-4144","authenticated-orcid":false,"given":"Yuyang","family":"Zhang","sequence":"first","affiliation":[{"name":"Tianjin Medical University"},{"name":"Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulu","family":"Wang","sequence":"additional","affiliation":[{"name":"Tianjin Medical University"},{"name":"Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujiao","family":"Hao","sequence":"additional","affiliation":[{"name":"Tianjin Medical University"},{"name":"Tianjin Baodi Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Li","sequence":"additional","affiliation":[{"name":"Tianjin Medical University"},{"name":"Tianjin Huanhu Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0477-4711","authenticated-orcid":false,"given":"Bingxin","family":"Ma","sequence":"additional","affiliation":[{"name":"Tianjin Medical University"},{"name":"Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Yang","sequence":"additional","affiliation":[{"name":"Tianjin Medical University"},{"name":"Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiali","family":"Zheng","sequence":"additional","affiliation":[{"name":"Tianjin Medical University"},{"name":"Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8285-2220","authenticated-orcid":false,"given":"Xiaojun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Tianjin Medical University"},{"name":"Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaogang","family":"Wang","sequence":"additional","affiliation":[{"name":"Tianjin Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Lin","sequence":"additional","affiliation":[{"name":"Tianjin Medical University"},{"name":"Tianjin Medical University General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1778-1387","authenticated-orcid":false,"given":"Yue","family":"Zhao","sequence":"additional","affiliation":[{"name":"Tianjin Medical University"},{"name":"Tianjin Medical University"},{"name":"Joint Research Centre for Primary Health Care, The Hong Kong Polytechnic University, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4901-3449","authenticated-orcid":false,"given":"Qi","family":"Lu","sequence":"additional","affiliation":[{"name":"Tianjin Medical University"},{"name":"Tianjin Medical University"},{"name":"Joint Research Centre for Primary Health Care, The Hong Kong Polytechnic University, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_3_3_2_2","article-title":"Projections of the stroke burden at the global, regional, and national levels up to 2050 based on the global burden of disease study 2021","volume":"13","author":"Cheng Y","year":"2024","unstructured":"Cheng Y, Lin Y, Shi H, et al. 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