Ali Razmara1, Natalie Valle2, Daniela Markovic3, Nerses Sanossian4, Bruce Ovbiagele5, Tara Dutta6, Amytis Towfighi7. 1. Department of Neurology, Kaiser Permanente, Irvine, California. Electronic address: alirazmara@outlook.com. 2. Research Department, St. Jude Medical Center, Fullerton, California. 3. Department of Biomathematics, University of California Los Angeles, Los Angeles, California. 4. Department of Neurology, University of Southern California, Los Angeles, California. 5. Department of Neurology, Medical University of South Carolina, Charleston, South Carolina. 6. Department of Neurology, Kaiser Permanente, Sacramento, California. 7. Department of Neurology, University of Southern California, Los Angeles, California; Department of Neurology, Rancho Los Amigos National Rehabilitation Center, Downey, California.
Abstract
BACKGROUND: Poststroke depression is common, affecting approximately 1 in 3 stroke survivors. We aimed to evaluate the association between depression and mortality in adults with and without prior stroke. METHODS: Using the National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Follow-up Study (1982-1992), we investigated the association between depression and all-cause mortality among adults aged 25-74 years with and without prior stroke, and stroke mortality among stroke survivors, adjusting for covariates. RESULTS: Among 9919 individuals, 121 (1.2%) reported prior stroke. The adjusted depression prevalence was 37.1% among stroke survivors and 17.3% among individuals without stroke. In persons aged 25-64 years, neither stroke nor depression was associated with all-cause mortality. The combination of depression and stroke was not associated with all-cause mortality (adjusted hazard ratio [HR] 2.83, 95% confidence interval [CI] .67-12.04). Among persons aged 65-74 years, depression alone (adjusted HR 1.24, 95% CI 1.04-1.47), stroke alone (adjusted HR 1.64, 95% CI 1.17-2.32), and the combination of depression and stroke (adjusted HR 2.28, 95% CI 1.79-2.90) were associated with all-cause mortality, consistent with an additive relationship. Among all ages, the combination of depression and stroke was associated with all-cause mortality (adjusted HR 1.93, 95% CI 1.28-2.92). Higher stroke mortality was only observed in those aged 65-74 years (adjusted HR 2.43, 95% CI 1.05-5.60). Compared with stroke survivors without depression, those with depression were ~35 times more likely to die from a stroke (adjusted HR 35.33, 95% CI 7.79-160.32). CONCLUSIONS: The combination of prior stroke and depression is associated with higher all-cause mortality than either condition alone. The presence of depression after stroke increases stroke mortality 35-fold, highlighting the importance of identifying and treating depression among stroke survivors.
BACKGROUND:Poststroke depression is common, affecting approximately 1 in 3 stroke survivors. We aimed to evaluate the association between depression and mortality in adults with and without prior stroke. METHODS: Using the National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Follow-up Study (1982-1992), we investigated the association between depression and all-cause mortality among adults aged 25-74 years with and without prior stroke, and stroke mortality among stroke survivors, adjusting for covariates. RESULTS: Among 9919 individuals, 121 (1.2%) reported prior stroke. The adjusted depression prevalence was 37.1% among stroke survivors and 17.3% among individuals without stroke. In persons aged 25-64 years, neither stroke nor depression was associated with all-cause mortality. The combination of depression and stroke was not associated with all-cause mortality (adjusted hazard ratio [HR] 2.83, 95% confidence interval [CI] .67-12.04). Among persons aged 65-74 years, depression alone (adjusted HR 1.24, 95% CI 1.04-1.47), stroke alone (adjusted HR 1.64, 95% CI 1.17-2.32), and the combination of depression and stroke (adjusted HR 2.28, 95% CI 1.79-2.90) were associated with all-cause mortality, consistent with an additive relationship. Among all ages, the combination of depression and stroke was associated with all-cause mortality (adjusted HR 1.93, 95% CI 1.28-2.92). Higher stroke mortality was only observed in those aged 65-74 years (adjusted HR 2.43, 95% CI 1.05-5.60). Compared with stroke survivors without depression, those with depression were ~35 times more likely to die from a stroke (adjusted HR 35.33, 95% CI 7.79-160.32). CONCLUSIONS: The combination of prior stroke and depression is associated with higher all-cause mortality than either condition alone. The presence of depression after stroke increases stroke mortality 35-fold, highlighting the importance of identifying and treating depression among stroke survivors.
Authors: Li Liu; Matthew Fuller; Tyler P Behymer; Yisi Ng; Thomas Christianson; Shreyansh Shah; Nicolas Kon Kam King; Daniel Woo; Michael L James Journal: Stroke Date: 2020-03-04 Impact factor: 7.914
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Authors: Ghofran Khalid Alqurashi; Emad A Hindi; Mohamed A Zayed; Gamal S Abd El-Aziz; Hani A Alturkistani; Rabee F Ibrahim; Mona Ali Al-Thepyani; Refal Bakhlgi; Noor A Alzahrani; Ghulam Md Ashraf; Badrah S Alghamdi Journal: Behav Sci (Basel) Date: 2022-05-29