Abstract Details

Title Depression Is Associated with Higher Risk of Death among Stroke Survivors

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S49 - (-)

Poster/Presentation
Number 001

Objective

Background Up to one in three individuals with stroke develop depression. Although numerous studies have shown a link between depression and mortality after myocardial infarction; the association between depression and mortality among stroke survivors has not been evaluated.

Design/Methods The association between depressive symptoms (score ?16 on 20-item CES-D scale) and all-cause and stroke mortality were assessed among participants in the NHANES I Epidemiologic Follow-up Study (NHFES), a cohort of persons who participated in NHANES I in 1971-1975, were interviewed in 1982-1984 and followed through 1992. Cox proportional hazards regression was used to calculate multivariate-adjusted hazard ratios (HRs) of death for 4 groups: (i) with stroke, without depression (n=73); (ii) with stroke, with depression (n=48); (iii) without stroke, without depression (n=8,138); and (iv) without stroke, with depression (n=2,291), adjusting for demographic (age, sex and race) and socioeconomic (education level, income level and marital status) factors.

Results In unadjusted analysis, individuals with stroke and depression had over 4-fold higher odds of all-cause mortality (HR 4.23, 95% CI 2.71-6.59) than those with neither condition. Adjustment for sociodemographic factors attenuated the effect (HR 2.86, 95% CI 1.76-4.64). Individuals with both stroke and depression had a higher risk of stroke mortality in both unadjusted and adjusted analyses (HR 4.06, 95% CI 2.08-7.89 and 3.69, 95% CI 1.66-8.22) than those with neither condition.

Conclusions Stroke survivors with depression are [sim]3 times more likely to die of all causes and [sim]4 times more likely to die from stroke than those without stroke or depression. These findings highlight the importance of screening for and treating depression among stroke survivors.

Authors/Disclosures
Amy T. Towfighi, MD PRESENTER	Dr. Towfighi has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Law firms. The institution of Dr. Towfighi has received research support from NIH.
Natalie P. Valle, MPH	No disclosure on file
	No disclosure on file
Bruce I. Ovbiagele, MD, MSc, FAAN (San Francisco VA)	Dr. Ovbiagele has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Stroke Association. Dr. Ovbiagele has received research support from National Institutes of Health. Dr. Ovbiagele has a non-compensated relationship as a President with Society for Equity Neuroscience that is relevant to AAN interests or activities. Dr. Ovbiagele has a non-compensated relationship as a Board Member with World Stroke Organization that is relevant to AAN interests or activities.
Christine M. Stanley, PhD (Athena Diagnostics, Inc.)	No disclosure on file

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