Why is screening for anxiety after stroke important and what are the challenges?
Mood disturbances are common after stroke and associated with a poorer recovery. It is crucially important to both identify and address anxiety symptoms in stroke survivors, throughout the rehabilitation process, in order to reduce distress and improve their rehabilitation.
Accurate screening for anxiety is the first step in identifying stroke patients in need of further diagnosis and treatment. However, this can be problematic in older patients who are aged 65 years and over. This is because measures have been developed for younger adults and are often less suitable in older people, especially for those with mild cognitive problems (affecting their memory and thinking), which are a frequent complication of stroke.
Professor Ian Kneebone, the principal investigator on the study, said:
“Estimates are that anxiety is present in 18% to 25% of people after stroke and it makes a difference to recovery in terms of quality of life, social contacts, participation and functional ability.
"Few tools are validated to screen for anxiety after stroke, none specifically in older stroke survivors. The Stroke Association funded our study to assess the Geriatric Anxiety Inventory, a tool specifically designed for this purpose in older people."
What did the new research show?
According to Professor Kneebone:
"The Geriatric Anxiety Inventory performed well against a gold standard clinical interview with respect to detection of anxiety and was able to consistently identify the presence of anxiety on different occasions. It performed better than the most commonly used tool, the Hospital Anxiety and Depression Scale- Anxiety subscale.
"Better detection of anxiety means it is more likely to be treated with positive implications for emotional distress and potentially recovery in those with stroke."
Word from the Stroke Association
Ian Kneebone is currently Professor and Head of Discipline (Clinical Psychology) in the Graduate School of Health, University of Technology Sydney, Australia. At the time of receiving the Stroke Association grant for the study, he was Consultant Clinical Psychologist, Virgin Care, Surrey UK.
Professor Kneebone would like to thank the stroke survivors who gave up their time to support this project as well as the numerous clinical and research staff who helped identify and assess participants: Rhani Allen-Crooks, Stuart Anderson, Jean Berry, Emily Birks, Elise Crayton, Sophie Dewar, Amanda Edwards, Jade Fortune, Sandra Hobson, Evelyn Jones, Mary Kelly, Leanne Menlove, Elisabeth Otto, Darren Reynolds, Penny Sharp, Fiona Song, Champa Sumanasuriya, Karren Towgood and Jayne Wright.