Post-stroke neuropsychiatric profiles and their association with functional independence: A latent profile analysis

Background Post-stroke neuropsychiatric symptoms, including depression, sleep disturbance, and cognitive impairment, are common and may influence functional independence. However, the patterns of co-occurring symptoms and their relationship with functional outcomes remain unclear. This study aimed to identify distinct neuropsychiatric profiles in acute stroke patients and examine their association with functional independence. Methods A total of 417 stroke patients hospitalized in Guangzhou and Changchun from October 2024 to September 2025 were recruited. Data were collected using a general information questionnaire, the Patient Health Questionnaire-9, the Athens Insomnia Scale, the Eight-item Informant Interview to Differentiate Aging and Dementia, and the Barthel Index. Latent profile analysis identified types of neuropsychiatric disturbance, and multiple linear regression examined their associations with functional independence. Results Eighty-four percent of participants had two or more types of neuropsychiatric disturbances. Four profiles were identified: 16% asymptomatic (Profile 1), 10% mild depression–sleep–cognitive impairment (Profile 2), 66% mild depression–sleep disorder (Profile 3), and 8% major depression–sleep–cognitive disorder (Profile 4). Barthel Index scores were significantly lower in Profiles 2, 3, and 4 compared with Profile 1 ( F  = 7.55, P  < 0.001). Patients in Profile 4 had the highest odds of functional dependence. Mean scores for bathing, stair climbing, and grooming in Profile 4 were 1.71, 2.71, and 3.00, respectively, the lowest among all groups. Sensitivity analysis confirmed poorer functional independence in patients with neuropsychiatric disturbances ( t  = 7.59, P  = 0.007). Conclusions This study identified distinct post-stroke neuropsychiatric profiles and their graded association with functional independence. Patients with moderate-to-severe depression, sleep disturbance, and cognitive impairment had the poorest performance in complex daily activities such as bathing, stair climbing, and grooming. Tailoring strategies to neuropsychiatric profiles may enhance functional recovery.