Cataldo et al the Geriatric Assessment and Integrated Home Care (ADI) Unit of District 10, ASP 6, Palermo, Italy. The ADI Unit in- cludes an internal medicine specialist, a physiatrist, a social worker, a registered nurse, a physiotherapist and a visiting healthcare nurse and it collaborates with a geriatrician and a psychiatrist of the District Health Clinic. Data was col- lected regarding socio-demographic characteristics and the presence of vascular risk factors and comorbilities, such as hypertension, diabetes mellitus, dyslipidemia, coronary dis- ease or previous stroke. Etiology and location of the cerebral lesions were also registered. All patients included in the study were assessed through a multidimensional clinical approach both at admission and at the time of discharge. At first, the social worker through an interview with family members evaluated the home care organization of the patient. Then the multidisciplinary as- sessment was carried out by collecting anamnestic data and the clinical examination. The following scales were used: the Barthel index for activities of daily living, the Barthel mobility index for the functional evaluation and the Short Portable Mental Status Questionnaire (SPQM) for the cognitive evaluation [8, 9]. Depression was diagnosed according the DSM IV diagnostic criteria [10, 11] using, among the several scales developed and validated over the years to identify subjects likely to have depressive symptoms, the Hamilton Rating Scale for Depression (HDRS) [12, 13]. This scale consists of 21 items that focus on the typical symptoms of depression and are able to identify its degree of severity. The assessment of de- pression in the HDRS scale classifies subjects with stroke in non-depressed (0 - 7), mildly depressed (8 - 17), moderatly depressed (18 - 24) and severly depressed (over 25). The home rehabilitation program provided three one hour sessions a week (extensive rehabilitation) with thera- peutic exercises designed to obtain the recovery of func- tional movement. To evaluate the outcome of rehabilitation treatment, the Barthel scales of daily living activities and mobility were used. In contrast to most studies that have been conducted until now and in which a reliable assessment of depressive symp- toms with the actual post-stroke assessment scales had been considered impossible or unreliable with aphasic patients, in this study were included aphasic patients if they were able to answer to the Hamilton Rating Scale for Depression (HDRS) with simple yes or no answers or with gestures. The statistical analysis was performed with the software EpiInfoTM 3.5 (CDC, Atlanta, GA, USA). Due to the rela- tively small number of cases, for the statistical analysis the HDRS classes were collapsed into two, mild to moderate (≤ 17) and severe (≥ 18). The descriptive analysis was performed by calculating the mean (standard deviation) and frequencies and the significance of differences was assessed by one-way ANOVA test or Kruskall-Wallis, when appropriate, or with the chi-square test or the exact test of Fisher, respectively. The J Clin Med Res • 2010;2(1):39-43 associations between the variables under examination were evaluated using contingency tables. The results of the sta- tistical tests were considered significant for P values ≤ 0.05. Results Sixty-two out of the 103 subjects under study were of fe- male gender. The mean age of these patients was 76.6 ± 9.1 years with a significant difference by gender (F, 78.8 ± 8.5 vs. M, 73.1 ± 8.8, P = 0.001). The anamnestic data related to comorbilities, the clinical chemical parameters and the char- acteristics of the lesions are summarized in Table 1. Among the variables under analysis, only hypertension appeared sig- nificantly related to female gender (F, 90.3% vs. M, 68.3%, P = 0.003), whereas a positive anamnesis for a previous stroke was significantly more frequent in male gender (F, 24.2 vs. M, 46.3, P = 0.01). Twenty-nine subjects were aphasic. Aphasia appeared significantly associated with female gen- der (F, 35.5% vs. M, 17.1, P = 0,02). No patients were classified as non-depressed. The dis- tribution included 20 patients (19.4%) in the major depres- sion class and 83 (80.6%) in the mild to moderate class. The HDRS class did not appear significantly associated with age or gender or any socio-demographic variable, including age, Table 1. Socio-Demographic, Anamnestic Characteris- tics and Etiological Subtype/Location of the Lesion in the 103 Patients Under Study Characteristic Female gender Education (years) < 8 ≥ 8 Caregiver Household member other Hyperthension Coronaropathy Diabetes Dyslipidemy Previous stroke Location of the lesion Right emisphere Left emisphere other Etiological subtype* aterotrombotic cardioembolic Small vessels disease N (%) 62 (60.2) 91 (88.3) 12 (11.7) 77 (74.8) 26 (25.2) 84 (81.6) 15 (14.7) 38 (36.9) 23 (22.5) 34 (33.0) 33 (32.0) 56 (54.4) 14 (13.6) 55 (53.4) 51 (49.5) 32 (31.1) *The total is higher than 103, because some patients had a mixed subtype. 40 Articles © The authors, Journal compilation © J Clin Med Res and Elmer Press™, www.jocmr.org