{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T08:31:43Z","timestamp":1771057903517,"version":"3.50.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T00:00:00Z","timestamp":1662940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Stroke is a major cause of mortality and long-term physical and cognitive impairment. This study aims to: (1) examine the prevalence of depressive symptoms, disability and pain among Chinese adults with stroke; (2) test the associations of functional limitations and body pain with occurrence of depressive symptoms; (3) investigate gender and urban-rural disparities in these associations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study utilized the data from the China Health and Retirement Longitudinal Study in 2018, involving 969 patients with stroke among 17,970 participants aged \u2265 45 years. Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression (CES-D) Scale. We performed multivariable logistic regression models to estimate the associations between activities of daily life (ADL), instrumental activities of daily life (IADL) and pain with depressive symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Depressive symptoms were found among 40.2% of stroke patients, with a higher prevalence in females (48.2%) than males (32.7%). Prevalence of ADL limitations, IADL limitations and pain among stroke patients were 39.2, 49.8 and 14.0%, respectively. ADL and IADL limitations and pain were more prevalent among females and residents in rural areas. Multivariable regression analyses showed a significant association between ADL limitation (OR = 1.535, 95% CI = 1.168, 2.018), IADL limitation (OR = 1.666, 95% CI = 1.260, 2.203) and pain (OR = 2.122, 95% CI = 1.466, 3.073) with depressive symptoms. Stratified analyses revealed stronger associations among urban residents. Females had a higher association of ADL and IADL with depressive symptoms but similar in that of pain to the males. The impact of ADL and IADL in male patients is higher than in females, but the impact of pain on depressive symptoms is higher in female patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Depressive symptoms are common amongst post-stroke patients in China and are significantly associated with functional disability and physical pain. Our findings have implications for practitioners on the early assessment of pain and depression after stroke. Future research should explore effective intervention measures for physical-mental stroke complications.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2022.927856","type":"journal-article","created":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T05:18:41Z","timestamp":1662959921000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["The association between functional status and physical pain with depressive symptoms after a stroke event: A cross-sectional analysis of the China Health and Retirement Longitudinal Study 2018"],"prefix":"10.3389","volume":"13","author":[{"given":"William Yang","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luwen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingfeng","family":"Wan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoying","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinzi","family":"Jin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Sum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ameera","family":"Katar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lili","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig S.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e254","DOI":"10.1161\/CIR.0000000000000950","article-title":"Heart disease and stroke statistics-2021 update: a report from the American heart association","volume":"143","author":"Virani","year":"2021","journal-title":"Circulation."},{"key":"B2","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1161\/CIRCULATIONAHA.116.025250","article-title":"Prevalence, incidence, and mortality of stroke in china: results from a nationwide population-based survey of 480 687 adults","volume":"135","author":"Wang","year":"2017","journal-title":"Circulation."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1001\/jamaneurol.2017.2802","article-title":"Disability trajectories before and after stroke and myocardial infarction: the cardiovascular health study","volume":"74","author":"Dhamoon","year":"2017","journal-title":"JAMA Neurol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e006443","DOI":"10.1161\/JAHA.117.006443","article-title":"Longitudinal effect of stroke on cognition: a systematic review","volume":"7","author":"Tang","year":"2018","journal-title":"J Am Heart Assoc."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1111\/ijs.12357","article-title":"Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies","volume":"9","author":"Hackett","year":"2014","journal-title":"Int J Stroke."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1111\/ijs.12356","article-title":"Part II: predictors of depression after stroke and impact of depression on stroke outcome: an updated systematic review of observational studies","volume":"9","author":"Kutlubaev","year":"2014","journal-title":"Int J Stroke."},{"key":"B7","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1192\/bjp.bp.111.107664","article-title":"Natural history, predictors and outcomes of depression after stroke: systematic review and meta-analysis","volume":"202","author":"Ayerbe","year":"2013","journal-title":"Br J Psychiatry."},{"key":"B8","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1177\/0891988714527514","article-title":"Risk factors for poststroke depression: identification of inconsistencies based on a systematic review","volume":"27","author":"De Ryck","year":"2014","journal-title":"J Geriatr Psychiatry Neurol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"101863","DOI":"10.1016\/j.ajp.2019.101863","article-title":"Discriminative factors for post-stroke depression","volume":"48","author":"Ghaffari","year":"2020","journal-title":"Asian J Psychiatr."},{"key":"B10","doi-asserted-by":"publisher","first-page":"6675680","DOI":"10.1155\/2021\/6675680","article-title":"Predictors of instrumental activities of daily living performance in patients with stroke","volume":"2021","author":"Ghaffari","year":"2021","journal-title":"Occup Ther Int."},{"key":"B11","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/j.neurol.2017.11.011","article-title":"Pain after stroke: a review","volume":"174","author":"Delpont","year":"2018","journal-title":"Rev Neurol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1093\/ije\/dys203","article-title":"Cohort profile: the China health and retirement longitudinal study (CHARLS)","volume":"43","author":"Zhao","year":"2014","journal-title":"Int J Epidemiol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/S0749-3797(18)30622-6","article-title":"Screening for depression in well older adults: evaluation of a short form of the CES-D (center for epidemiologic studies depression scale)","volume":"10","author":"Andresen","year":"1994","journal-title":"Am J Prev Med."},{"key":"B14","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1002\/(SICI)1099-1166(199908)14:8<608::AID-GPS991>3.0.CO;2-Z","article-title":"Cross-validation of a short form of the CES-D in Chinese elderly","volume":"14","author":"Boey","year":"1999","journal-title":"Int J Geriatr Psychiatry."},{"key":"B15","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1093\/geront\/9.3_Part_1.179","article-title":"Assessment of older people: self-maintaining and instrumental activities of daily living","volume":"9","author":"Lawton","year":"1969","journal-title":"Gerontologist."},{"key":"B16","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.pmn.2020.10.004","article-title":"The association between pain and fall among middle-aged and older Chinese","volume":"22","author":"Li","year":"2021","journal-title":"Pain Manag Nurs."},{"key":"B17","doi-asserted-by":"publisher","first-page":"e78981","DOI":"10.1371\/journal.pone.0078981","article-title":"A prospective study of the incidence and correlated factors of post-stroke depression in China","volume":"8","author":"Zhang","year":"2013","journal-title":"PLoS ONE."},{"key":"B18","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1080\/01616412.2017.1364514","article-title":"Post-stroke depression: different characteristics based on follow-up stage and gender-a cohort perspective study from Mainland China","volume":"39","author":"Wang","year":"2017","journal-title":"Neurol Res."},{"key":"B19","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1186\/s12877-016-0347-6","article-title":"The prevalence of stroke and depression and factors associated with depression in elderly people with and without stroke","volume":"16","author":"H\u00f6rnsten","year":"2016","journal-title":"BMC Geriatr."},{"key":"B20","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.genhosppsych.2020.06.011","article-title":"Post-stroke depression: a 2020 updated review","volume":"66","author":"Medeiros","year":"2020","journal-title":"Gen Hosp Psychiatry."},{"key":"B21","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1161\/01.STR.29.2.368","article-title":"Depression after stroke: results of the FINNSTROKE study","volume":"29","author":"Kotila","year":"1998","journal-title":"Stroke."},{"key":"B22","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1176\/jnp.10.1.41","article-title":"Gender differences in poststroke depression","volume":"10","author":"Paradiso","year":"1998","journal-title":"J Neuropsychiatry Clin Neurosci."},{"key":"B23","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1016\/j.jocn.2006.01.025","article-title":"Longitudinal prevalence and determinants of early mood disorder post-stroke","volume":"14","author":"Townend","year":"2007","journal-title":"J Clin Neurosci."},{"key":"B24","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1159\/000365838","article-title":"Gender and stress in predicting depressive symptoms following stroke","volume":"38","author":"Mazure","year":"2014","journal-title":"Cerebrovasc Dis."},{"key":"B25","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1097\/01376517-200609000-00008","article-title":"Poststroke depression incidence and risk factors: an integrative literature review","volume":"38","author":"Johnson","year":"2006","journal-title":"J Neurosci Nurs."},{"key":"B26","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1016\/S1474-4422(14)70016-X","article-title":"Neuropsychiatric outcomes of stroke","volume":"13","author":"Hackett","year":"2014","journal-title":"Lancet Neurol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"2311","DOI":"10.1161\/01.STR.29.11.2311","article-title":"Frequency and clinical determinants of poststroke depression","volume":"29","author":"Pohjasvaara","year":"1998","journal-title":"Stroke."},{"key":"B28","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1176\/jnp.10.1.26","article-title":"Functional impairment associated with acute poststroke depression: the stroke data bank study","volume":"10","author":"Ramasubbu","year":"1998","journal-title":"J Neuropsychiatry Clin Neurosci."},{"key":"B29","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1161\/01.STR.0000048149.84268.07","article-title":"Poststroke depression: an 18-month follow-up","volume":"34","author":"Berg","year":"2003","journal-title":"Stroke."},{"key":"B30","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1159\/000375397","article-title":"Post stroke pain: identification, assessment, and therapy","volume":"39","author":"Harrison","year":"2015","journal-title":"Cerebrovasc Dis."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1161\/01.STR.31.6.1223","article-title":"Medical complications after stroke: a multicenter study","volume":"31","author":"Langhorne","year":"2000","journal-title":"Stroke."},{"key":"B32","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1080\/16501970213237","article-title":"Long-term pain conditions after a stroke","volume":"34","author":"Widar","year":"2002","journal-title":"J Rehabil Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1097\/MRR.0b013e328010c7b8","article-title":"Prevalence and predictors of pain and fatigue after stroke: a population-based study","volume":"29","author":"Appelros","year":"2006","journal-title":"Int J Rehabil Res."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000451034","article-title":"The course of activities in daily living: who is at risk for decline after first ever stroke?","volume":"43","author":"Wondergem","year":"2017","journal-title":"Cerebrovasc Dis."},{"key":"B35","doi-asserted-by":"publisher","first-page":"17330","DOI":"10.1038\/s41598-019-53848-1","article-title":"Geographical difference, rural-urban transition and trend in stroke prevalence in China: findings from a national epidemiological survey of stroke in China","volume":"9","author":"Ru","year":"2019","journal-title":"Sci Rep."},{"key":"B36","doi-asserted-by":"publisher","first-page":"e15782","DOI":"10.1097\/MD.0000000000015782","article-title":"Urban-rural differences in risk factors for ischemic stroke in Northern China","volume":"98","author":"Li","year":"2019","journal-title":"Medicine."},{"key":"B37","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1212\/WNL.0000000000004056","article-title":"Rapid transitions in the epidemiology of stroke and its risk factors in China from 2002 to 2013","volume":"89","author":"Guan","year":"2017","journal-title":"Neurology."},{"key":"B38","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1002\/(SICI)1099-1166(199702)12:2<219::AID-GPS581>3.0.CO;2-E","article-title":"Risk factors for post-stroke depression","volume":"12","author":"Burvill","year":"1997","journal-title":"Int J Geriatr Psychiatry"},{"key":"B39","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1186\/s12888-021-03587-3","article-title":"Association between physical limitations and depressive symptoms among Indian elderly: marital status as a moderator","volume":"21","author":"Hossain","year":"2021","journal-title":"BMC Psychiatry."},{"key":"B40","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1161\/STROKEAHA.119.027039","article-title":"Depressive symptoms after ischemic stroke: population-based comparisons of patients and caregivers with matched controls","volume":"51","author":"Roth","year":"2020","journal-title":"Stroke."},{"key":"B41","doi-asserted-by":"publisher","first-page":"495","DOI":"10.2340\/16501977-1959","article-title":"Changes in life habits affected by mild stroke and their association with depressive symptoms","volume":"47","author":"Rozon","year":"2015","journal-title":"J Rehabil Med."},{"key":"B42","doi-asserted-by":"publisher","first-page":"2548","DOI":"10.1080\/09638288.2018.1471742","article-title":"Longitudinal changes in activity participation in the first year post-stroke and association with depressive symptoms","volume":"41","author":"Tse","year":"2019","journal-title":"Disabil Rehabil."},{"key":"B43","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1080\/09602011.2013.801778","article-title":"Depressive symptoms in acute stroke: A cross-sectional study of their association with sociodemographics and clinical factors","volume":"23","author":"Kouwenhoven","year":"2013","journal-title":"Neuropsychol Rehabil."}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.927856\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T05:18:46Z","timestamp":1662959926000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.927856\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,12]]},"references-count":43,"alternative-id":["10.3389\/fpsyt.2022.927856"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2022.927856","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,12]]},"article-number":"927856"}}