BACKGROUND: Several lines of evidence indicate that depression is importantly associated with cardiovascular disease end points. However, little is known about the role of depression in stroke mortality. METHODS: This study examined the association between depressive symptoms and stroke mortality in a prospective study of behavioral, social, and psychological factors related to health and mortality in a community sample of 6676 initially stroke-free adults (45.8% male; 79.1% white; mean age at baseline, 43.4 years) from Alameda County, California. Depressive symptoms were assessed by the 18-item Human Population Laboratory Depression Scale. Cox proportional hazards regression models were used to evaluate the impact of depressive symptoms after controlling for age, sex, race, and other confounders. RESULTS: A total of 169 stroke deaths occurred during 29 years of follow-up. Reporting 5 or more depressive symptoms at baseline was associated with increased risk of stroke mortality, after adjusting for age, sex, and race (hazard ratio, 1.66; 95% confidence interval, 1.16-2.39; P<.006). This association remained significant after additional adjustments for education, alcohol consumption, smoking, body mass index, hypertension, and diabetes (hazard ratio, 1.54; 95% confidence interval, 1.06-2.22; P<.02). Time-dependent covariate models, which allowed changes in reported depressive symptoms and risk factor levels during follow-up, revealed the same pattern of associations. CONCLUSIONS: This population-based study provides the strongest epidemiological evidence to date for a significant relationship between depressive symptoms and stroke mortality. These results contribute to the growing literature on the adverse health effects of depression.
BACKGROUND: Several lines of evidence indicate that depression is importantly associated with cardiovascular disease end points. However, little is known about the role of depression in stroke mortality. METHODS: This study examined the association between depressive symptoms and stroke mortality in a prospective study of behavioral, social, and psychological factors related to health and mortality in a community sample of 6676 initially stroke-free adults (45.8% male; 79.1% white; mean age at baseline, 43.4 years) from Alameda County, California. Depressive symptoms were assessed by the 18-item Human Population Laboratory Depression Scale. Cox proportional hazards regression models were used to evaluate the impact of depressive symptoms after controlling for age, sex, race, and other confounders. RESULTS: A total of 169 stroke deaths occurred during 29 years of follow-up. Reporting 5 or more depressive symptoms at baseline was associated with increased risk of stroke mortality, after adjusting for age, sex, and race (hazard ratio, 1.66; 95% confidence interval, 1.16-2.39; P<.006). This association remained significant after additional adjustments for education, alcohol consumption, smoking, body mass index, hypertension, and diabetes (hazard ratio, 1.54; 95% confidence interval, 1.06-2.22; P<.02). Time-dependent covariate models, which allowed changes in reported depressive symptoms and risk factor levels during follow-up, revealed the same pattern of associations. CONCLUSIONS: This population-based study provides the strongest epidemiological evidence to date for a significant relationship between depressive symptoms and stroke mortality. These results contribute to the growing literature on the adverse health effects of depression.
Authors: A J Thomas; I N Ferrier; R N Kalaria; R H Perry; A Brown; J T O'Brien Journal: J Neurol Neurosurg Psychiatry Date: 2001-01 Impact factor: 10.154
Authors: Lesli E Skolarus; John D Piette; Paul N Pfeiffer; Linda S Williams; Jason Mackey; Rebecca Hughes; Lewis B Morgenstern Journal: Transl Stroke Res Date: 2016-07-09 Impact factor: 6.829
Authors: Lesli E Skolarus; Lynda D Lisabeth; Brisa N Sánchez; Melinda A Smith; Nelda M Garcia; Jan M H Risser; Lewis B Morgenstern Journal: J Relig Health Date: 2012-12
Authors: Frank C Bandiera; Alberto J Caban-Martinez; Kristopher L Arheart; Evelyn P Davila; Lora E Fleming; Noella A Dietz; John E Lewis; David Fabry; David J Lee Journal: Ann Behav Med Date: 2010-05
Authors: Pamela H Mitchell; Richard C Veith; Kyra J Becker; Ann Buzaitis; Kevin C Cain; Michael Fruin; David Tirschwell; Linda Teri Journal: Stroke Date: 2009-08-06 Impact factor: 7.914