ABSTRACT NUMBER: ESOC2026A1456 FREQUENCY AND PATTERNS OF PRESTROKE NEUROPSYCHIATRIC SYMPTOMS

Abstract Background and aims In a cohort of patients with acute cerebrovascular events, we aimed to describe the frequency and severity of prestroke neuropsychiatric symptoms. Methods We included consecutive patients admitted to our stroke unit (April 2019 - December 2024). Prestroke NPS were screened using Neuropsychiatric Inventory questionnaire (NPI-q), an informant-based tool consisting of 12 items. Prestroke cognitive impairment was defined as an IQCODE (Informant Questionnaire for Cognitive Decline in the Elderly) score >3.3. Frequency of prestroke neuropsychiatric symptoms were reported and compared between subgroups of patients using univariate analyses. Results Of 1058 patients admitted, 864 underwent prestroke neuropsychiatric screening and were included in the study (median age 78.5 years; 54.3% male; 35.0% with prestroke cognitive impairment). Five hundred sixty-four patients (65.6%) exhibited at least one prestroke neuropsychiatric symptom; the most frequent were depression/dysphoria (33.8%), sleep disturbance (29.4%), apathy (26.5%), irritability/liability (24.8%), anxiety (23.5%). Compared to males, females had more depression (39.5% vs. 29.0%, p<0.001), less irritability (20.8% vs. 28.1%, p=0.012), more anxiety (32.9% vs. 15.6%, p<0.001). Compared to patients <80 years old, older patients had more depression/dysphoria (40.8% vs. 28.1%, p<0.001), sleep disturbance (34.1% vs. 25.5%, p=0.006), and apathy (31.8% vs. 22.2%, p<0.001). Compared to patients without cognitive decline, those with prestroke cognitive decline had more depression/dysphoria (49.3% vs. 25.4%, p<0.001), sleep disturbance (41.1% vs. 23.1%, p<0.001), apathy (51.3% vs. 13.2%, p<0.001), irritability (35.8% vs. 18.9%, p<0.001), and anxiety (31.5% vs. 19.2%, p<0.001). Conclusions Prestroke neuropsychiatric symptoms were common, especially in patients with cognitive impairment, and showed sex-specific patterns. Conflict of interest All authors have nothing to disclose