Prevalence of depression in post-stroke aphasia: systematic review and meta-analysis

Depression is a significant consequence of post-stroke aphasia, adversely affecting quality of life; however, its frequency remains unclear. The objective of this systematic review and meta-analysis is to quantify depression prevalence rates among individuals with post-stroke aphasia. We systematically reviewed studies on depression in post-stroke aphasia, conducting a meta-analysis that focused on the frequency of depression using diagnostic tools. We conducted a systematic search to identify studies reporting original data on depression frequency in individuals with post-stroke aphasia. From each included study, we extracted data on patient characteristics, diagnostic methods, and aphasia-friendliness. The quality of each study was assessed to ensure reliability and accuracy. We estimated the pooled prevalence using random effect models. Sixteen articles, conducted between 1993 and 2023, met our inclusion criteria. The pooled prevalence of post-stroke depression in people with aphasia was 31.7% (95% CI = 0.2354, 0.4044). Self-reports were the most common method for assessing depression, with participants’ average time post-stroke onset being 1.75 years (range = 0.02–6.76 years). Our meta-analysis found no significant difference in depression prevalence between self-reported and proxy-reported measures, nor any effect of time post-stroke onset on depression. Depression is a common concern in post-stroke aphasia. The lack of observed effects from assessment method or time since stroke may be due to methodological inconsistencies in reporting across studies. Psychometrically sound assessment tools validated for people with aphasia, along with more consistent reporting of patient characteristics, are essential for improving depression screening and mental health care in this population.