Impact of lifestyle factors on depression, anxiety, and functional recovery in ischemic stroke survivors in Bangladesh: a cross-sectional study

Stroke is one of the major causes of death and disability both globally and in Bangladesh. Lifestyle traits are already known as a major indicator of healthy living and they might have relationships with post-stroke outcomes. This study aimed to examine how various lifestyle factors; including physical activity, dietary habits, smoking, alcohol use, and sleep quality affect the psychological health like depression, anxiety and functional recovery of ischemic stroke survivors in Bangladesh. A cross-sectional study was conducted from January 2021 to June 2024, involving 1052 ischemic stroke patients from different areas of Bangladesh. Data were collected through interviews and standardized tools like the Barthel Index for activities of daily living, and the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 for psychological assessment. The majority of 1052 ischemic stroke patients were male (68%) and older than 50 (69.5%). Notable comorbidity rates (hypertension, 77.9%; diabetes, 58.4%; heart disease, 54%) were also observed. Dietary pattern included increased fast food (57.1%) and fish (56.2%) consumption and less fruit (51.8%) intake. The majority were addicted to smoking (56.6%) and smokeless tobacco (59.1%). Patients 53 years and above showed higher odds of decreased functional independence (OR = 0.64). While obese patients were observed to have increased anxiety risk (OR = 3.30) and decreased functional independence (OR = 1.34). Patients who performed physical exercise before stroke showed higher odds of improved physical function (OR = 1.35). The habit of extra salt consumption among patients showed depressive symptoms (OR = 1.34). In addition, patients who had adequate sleep (≥ 8 h) were observed to have fewer depressive symptoms (OR = 0.29). Patients who were light smokers (OR = 0.68) were observed to have less chance of developing depressive symptoms than heavy smokers. Nevertheless, smokeless tobacco consumption habit increased chances of anxiety (OR = 3.34) and depressive (OR = 1.43) symptoms. Stroke patients with anxiety, depression and poor functional outcome show specific lifestyle traits. Further study should focus on improving the psychological and functional outcome through structured patient education system and lifestyle modifications.