Depressive Symptoms and Risk of Stroke in a National Cohort of Black and White Participants From REGARDS
dc.contributor.author | Ford, Cassandra D. | |
dc.contributor.author | Gray, Marquita S. | |
dc.contributor.author | Crowther, Martha R. | |
dc.contributor.author | Wadley, Virginia G. | |
dc.contributor.author | Austin, Audrey L. | |
dc.contributor.author | Crowe, Michael G. | |
dc.contributor.author | Pulley, LeaVonne | |
dc.contributor.author | Unverzagt, Frederick | |
dc.contributor.author | Kleindorfer, Dawn O. | |
dc.contributor.author | Kissela, Brett M. | |
dc.contributor.author | Howard, Virginia J. | |
dc.contributor.department | Psychiatry, School of Medicine | |
dc.date.accessioned | 2023-08-11T15:13:16Z | |
dc.date.available | 2023-08-11T15:13:16Z | |
dc.date.issued | 2021 | |
dc.description.abstract | Objective: The purpose of this study was to examine depressive symptoms as a risk factor for incident stroke and determine whether depressive symptomatology was differentially predictive of stroke among Black and White participants. Methods: The study comprised 9,529 Black and 14,516 White stroke-free participants, aged 45 and older, enrolled in the REasons for Geographic and Racial Differences in Stroke (2003-2007). Incident stroke was the first occurrence of stroke. Association between baseline depressive symptoms (assessed via the 4-item Center for Epidemiologic Studies Depression Scale [CES-D-4]: 0, 1-3, or ≥4) and incident stroke was analyzed with Cox proportional hazards models adjusted for demographics, stroke risk factors, and social factors. Results: There were 1,262 strokes over an average follow-up of 9.21 (SD 4.0) years. Compared to participants with no depressive symptoms, after demographic adjustment, participants with CES-D-4 scores of 1-3 had 39% increased stroke risk (hazard ratio [HR] = 1.39, 95% confidence interval [CI] = 1.23-1.57), with slight attenuation after full adjustment (HR = 1.27, 95% CI = 1.11-1.43). Participants with CES-D-4 scores of ≥4 experienced 54% higher risk of stroke after demographic adjustment (HR = 1.54, 95% CI = 1.27-1.85), with risk attenuated in the full model similar to risk with 1-3 symptoms (HR = 1.25, 95% CI = 1.03-1.51). There was no evidence of a differential effect by race (p = 0.53). Conclusions: The association of depressive symptoms with increased stroke risk was similar among a national sample of Black and White participants. These findings suggest that assessment of depressive symptoms should be considered in primary stroke prevention for both Black and White participants. | |
dc.eprint.version | Final published version | |
dc.identifier.citation | Ford CD, Gray MS, Crowther MR, et al. Depressive Symptoms and Risk of Stroke in a National Cohort of Black and White Participants From REGARDS. Neurol Clin Pract. 2021;11(4):e454-e461. doi:10.1212/CPJ.0000000000000983 | |
dc.identifier.uri | https://hdl.handle.net/1805/34853 | |
dc.language.iso | en_US | |
dc.publisher | Wolters Kluwer | |
dc.relation.isversionof | 10.1212/CPJ.0000000000000983 | |
dc.relation.journal | Neurology: Clinical Practice | |
dc.rights | Publisher Policy | |
dc.source | PMC | |
dc.subject | Risk factors | |
dc.subject | Stroke | |
dc.subject | Depressive symptomatology | |
dc.title | Depressive Symptoms and Risk of Stroke in a National Cohort of Black and White Participants From REGARDS | |
dc.type | Article | |
ul.alternative.fulltext | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8382440/ |