Depression and risk of stroke in midaged women: a prospective longitudinal study

Jackson, Caroline A. and Mishra, Gita D. (2013) Depression and risk of stroke in midaged women: a prospective longitudinal study. Stroke, 44 6: 1555-1560. doi:10.1161/STROKEAHA.113.001147


Author Jackson, Caroline A.
Mishra, Gita D.
Title Depression and risk of stroke in midaged women: a prospective longitudinal study
Journal name Stroke   Check publisher's open access policy
ISSN 0039-2499
1524-4628
Publication date 2013-06
Sub-type Article (original research)
DOI 10.1161/STROKEAHA.113.001147
Volume 44
Issue 6
Start page 1555
End page 1560
Total pages 6
Place of publication United States
Publisher Lippincott Williams & Wilkins
Collection year 2014
Language eng
Formatted abstract
Background and Purpose—Depression is known to increase stroke risk. Although limited, there is some evidence for age differences, with a suggestion for a stronger association in younger groups. We investigated the effect of depression on stroke incidence in a large cohort of midaged women.

Methods—We included 10 547 women without a history of stroke aged 47 to 52 years from the Australian Longitudinal Study on Women’s Health, surveyed every 3 years from 1998 to 2010. Depression was defined at each survey using the Center for Epidemiological Studies Depression Scale (shortened version) and antidepressant use in the past month. Stroke was ascertained through self-report and mortality data. We determined the association between depression and stroke at the subsequent survey, using generalized estimating equation analysis, adjusting for time-varying covariates.

Results—At each survey, ≈24% were defined as having depression. During follow-up, 177 strokes occurred. Depression was associated with a >2-fold increased odds of stroke (odds ratio, 2.41; 95% confidence interval, 1.78–3.27), which attenuated after adjusting for age, socioeconomic status, lifestyle, and physiological factors (odds ratio, 1.94; 95% confidence interval, 1.37–2.74). Findings were robust to sensitivity analyses addressing methodological issues, including definition of depression, antidepressant use, and missing covariate data.

Conclusions—Depression is a strong risk factor for stroke in midaged women, with the association partially explained by lifestyle and physiological factors. Further studies of midaged and older women from the same population are needed to confirm whether depression is particularly important in younger women and to inform targeted intervention approaches.
Keyword Cerebrovascular disease
Depression
Mental health
Stroke
Epidemiology
Prevalence
Metaanalysis
Mortality
Disease
Validation
Episode
Cohort
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
 
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