Depression Following Small Vessel Stroke is Common and More Prevalent in Women.
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2024-02
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Abstract
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We sought to examine the frequency of depression after small vessel-type stroke (SVS) and associated risk factors.Materials and methods
We conducted a retrospective analysis of a prospective cohort of patients enrolled in the American Stroke Association-Bugher SVS Study, which included 200 participants within 2-years of SVS and 79 controls without a history of stroke from 2007 to 2012 at four sites. The primary outcome was PHQ-8, with scores ≥10 consistent with post-stroke depression (PSD). A logistic regression adjusted for age, race, sex, history of diabetes and Short-Form Montreal Cognitive Assessment score (SF-MoCA) was used to compare the risk of having depression after SVS compared to controls. Another logistic regression, adjusted for age, sex, race, level of education, SF-MoCA, white matter disease (WMD) burden, stroke severity (NIHSS), time between stroke and depression screen, history of diabetes, and history of hypertension was used to identify factors independently associated with depression in participants with SVS.Results
The cohort included 161 participants with SVS (39 excluded due to missing data) and 79 controls. The mean interval between stroke and depression screening was 74 days. Among participants with SVS, 31.7% (n=51) had PSD compared to 6.3% (n=5) of controls (RR= 5.44, 95% CI=2.21-13.38, p=0.0002). The only two variables independently associated with PSD in participants with SVS were female sex (RR=1.84, 95% CI=1.09-3.09, p=0.020) and diabetes (RR 1.69, 95% CI 1.03-2.79).Conclusions
After adjusting for several demographic and clinical variables, having a SVS was associated with an approximate 5-fold increased risk of depression and was more frequent in women and in those with diabetes. The extent of WMD was not independently associated with PSD, suggesting that small vessel disease in the setting of an overt SVS may not account for the increased prevalence of depression.Type
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Dymm, Braydon, Larry B Goldstein, Shakthi Unnithan, Hussein R Al-Khalidi, Deborah Koltai, Cheryl Bushnell and Nada El Husseini (2024). Depression Following Small Vessel Stroke is Common and More Prevalent in Women. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. p. 107646. 10.1016/j.jstrokecerebrovasdis.2024.107646 Retrieved from https://hdl.handle.net/10161/30217.
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Scholars@Duke
Braydon Leigh Dymm
Shakthi Unnithan
Shakthi earned her Master's in Statistics with a concentration in biostatistics from North Carolina State University. Shakthi currently collaborates with researchers in the Department of Obstetrics and Gynecology and Department of Neurology. Her statistical interests include regression modeling and machine learning techniques for high dimensional data.
Hussein Rashid Al-Khalidi
My research interest includes design and analysis of cardiovascular clinical trials, medical devices, survival analysis, group-sequential analysis, time-to-recurrent or multiple events, continuous-time Markov models, stochastic process, linear model, dose-response modeling, design of experiments and adaptive designs.
Deborah Koltai
- Investigation of factors related to care of epilepsy patients in Uganda, Africa to inform capacity building and infrastructure strengthening efforts. Studies have involved a pursuit of understanding the cultural context and its impact on health care delivery and utilization.
2) Development and psychometric validation of neuropsychological and behavioral instruments.
3) The effect of psychological interventions on the abilities and adjustment of dementia patients and those at-risk for developing neurodegenerative illnesses such as Alzheimer's disease. Interventions include modified cognitive (mnemonic; organizational) strategies, and traditional psychotherapy (dynamic and behavioral).
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