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Karger_ESC London_2013

London, United Kingdom 2013 Table Associations between depression and stroke risk in primary and sensitivity analyses Fully adjusteda Analyses OR (95% CI) P-value Primary analysis CESD-10 score ≥10 or taking anti-depressant medication 1.94 (1.37 to 2.74) <0.001 Sensitivity analyses Definition of depression CESD-10 score ≥10 1.96 (1.37 to 2.81) <0.001 CESD-10 score ≥10 or doctor diagnosed de-pression 2.10 (1.49 to 2.96) <0.001 CESD-10 score ≥10 or taking anti-depressant 2.03 (1.44 to 2.86) <0.001 medication or doctor diagnosed depression CESD-10 score ≥10, having excluded all those taking anti-depressant medication 1.81 (1.22 to 2.70) 0.003 Repeat of primary analysis using multiple impu-tation Cerebrovasc Dis 2013; 35 (suppl 3)1-854 51 to impute missing covariate data 1.98 (1.44 to 2.72) <0.001 aAdjusted for age, education, homeownership, hypertension, diabetes, heart disease, hysterecto-my/ oophorectomy, smoking, alcohol use, physical activity and body mass index OR = odds ratio; CI = confidence interval; BMI = body mass index 4 Etiology of stroke and risk factors A 15:00 - 15:10 Depression and risk of stroke in Australian mid-age women: a prospective, popula-tion- based study C.A. Jackson1, G.D. University of Queensland, Brisbane, AUSTRALIA1,University of Queensland, Brisbane, AUSTRALIA2 Background Depression is thought to increase stroke risk by about 35%. Al-though limited, there is evidence for important age differences, with a suggestion for an even stronger association in younger groups. We therefore examined the ef-fect of depression on stroke incidence in a population-based cohort of mid-aged women. Methods We included 10,546 women without a history of stroke aged 47-52 years from the Australian Longitudinal Study on Women’s Health, surveyed every three years from 1998 to 2010. Depression was defined at each survey by a Center for Epidemiological Studies De-pression scale (shortened version) score of >/=10, or past month anti-depressant use. Stroke was ascertained through self-report and mortality data. We determined the association be-tween depression and stroke at the subsequent survey, using generalised estimating equation regression models for binary outcome data. We adjusted for time-varying covariates, includ-ing: socioeconomic and marital status; history of hypertension, heart disease, diabetes and hysterectomy/oophorectomy; smoking, physical activity, alcohol use and body mass index. Results At each survey, about 24% of women were defined as depressed. During 12 years of fol-low- up 177 strokes occurred. In crude analyses, depression increased stroke risk more than two-fold (OR 2.41, 95% CI 1.78, 3.27). This relationship attenuated to OR 1.94 (95% CI 1.37, 2.74) after adjustment for confounders. Findings were robust to sensitivity analyses addressing meth-odological issues such as definition of depression, anti-depressant use and missing covariate data. Conclusion Our findings suggest that depression is a strong risk factor for stroke in mid-aged women, with the association only partially explained by lifestyle and physiological factors. Fur-ther research is needed to confirm whether depression is an important stroke risk factor in mid-age women in particular, to inform development of targeted prevention and intervention approaches.


Karger_ESC London_2013
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