The association of depression, cognitive impairment without dementia, and dementia with risk of ischemic stroke: A cohort study

TitleThe association of depression, cognitive impairment without dementia, and dementia with risk of ischemic stroke: A cohort study
Publication TypeJournal Article
Year of Publication2015
AuthorsDavydow, DS, Levine, DA, Zivin, K, Katon, WJ, Langa, KM
JournalPsychosomatic Medicine
Volume77
Issue2
Pagination200-208
KeywordsHealth Conditions and Status, Methodology, Other, Risk Taking
Abstract

Objective: To determine if depression, cognitive impairment without dementia (CIND), and/or dementia are each independently associated with risk of ischemic stroke and to identify characteristics that could modify these associations. Methods: This retrospective-cohort study examined a population-based sample of 7031 Americans older than 50 years participating in the Health and Retirement Study (1998-2008) who consented to have their interviews linked to their Medicare claims. The eight-item Center for Epidemiologic Studies Depression Scale and/or International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) depression diagnoses were used to identify baseline depression. The Modified Telephone Interview for Cognitive Status and/or ICD-9-CM dementia diagnoses were used to identify baseline CIND or dementia. Hospitalizations for ischemic stroke were identified via ICD-9-CM diagnoses. Results: After adjusting for demographics, medical comorbidities, and health-risk behaviors, CIND alone (odds ratio OR = 1.37, 95 confidence interval CI = 1.11-1.69) and co-occurring depression and CIND (OR = 1.65, 95 CI = 1.24-2.18) were independently associated with increased odds of ischemic stroke. Depression alone was not associated with odds of ischemic stroke (OR = 1.11, 95 CI = 0.88-1.40) in unadjusted analyses. Neither dementia alone (OR = 1.09, 95 CI = 0.82-1.45) nor co-occurring depression and dementia (OR = 1.25, 95 CI = 0.89-1.76) were associated with odds of ischemic stroke after adjusting for demographics. Conclusions: CIND and co-occurring depression and CIND are independently associated with increased risk of ischemic stroke. Individuals with co-occurring depression and CIND represent a high-risk group that may benefit from targeted interventions to prevent stroke.

DOI10.1097/psy.0000000000000136
Citation Key8323
PubMed ID25647752
PubMed Central IDPMC4333011