title: Natural history, predictors and associated outcomes of anxiety up to 10 years after stroke: the South London Stroke Register.
abstract: BACKGROUND
  evidence on the long-term natural history, predictors and outcomes of anxiety after stroke is insufficient to inform effective interventions. This study estimates within 10 years of stroke: (i) the incidence, cumulative incidence, prevalence, and time of onset of anxiety. (ii) Predictors of anxiety and its association with depression. (iii) The association between anxiety 3 months after stroke and mortality, stroke recurrence, disability, cognitive impairment and quality of life (QoL) at follow-up.
  
  
  METHODS
  data from the South London Stroke Register (1995-2010). Patients were assessed at the time of the stroke, at 3 months, 1 year and then annually for up to 10 years. Baseline data included socio-demographics and stroke severity. Follow-up data included assessments for anxiety and depression (hospital anxiety and depression scale), disability, cognition and QoL. Multivariate regression was used to investigate predictors and associated outcomes of anxiety.
  
  
  RESULTS
  incidence of anxiety up to 10 years ranged from 17 to 24%. Cumulative incidence: 57%. Prevalence range: 32-38%. Amongst patients with anxiety, 58% were anxious at 3 months. 57-73% of patients with anxiety had co-morbid depression. Predictors of anxiety included age under 65, female gender, inability to work, depression treatment, smoking and stroke severity. Anxiety at 3 months was associated with lower QoL at follow-up.
  
  
  CONCLUSIONS
  anxiety is a frequent problem affecting stroke survivors in the long term. Clinicians should pay attention to patients at risk of anxiety since it is associated with lower QoL and depression.
authors.affiliation: Blizard Institute, Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK, London E12AB, UK Division of Health and Social Care Research, King's College London, London, UK.
authors.forename: Luis
authors.initials: L
authors.lastname: Ayerbe
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK.
authors.forename: Salma A
authors.initials: SA
authors.lastname: Ayis
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Crichton
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK.
authors.forename: Charles D A
authors.initials: CD
authors.lastname: Wolfe
authors.affiliation: Division of Health and Social Care Research, King's College London, London, UK.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Rudd
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology*; D003071:Cognition; D003863:Depression / Q000453:epidemiology* / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012042:Registries; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000523:psychology*
keywords: anxiety; cohort studies; incidence; older people; prevalence; stroke