Depression as a risk factor for the incidence of first-ever stroke in 85-year-olds
Depression as a risk factor for the incidence of first-ever stroke in 85-year-olds
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DOI：
10.1161/strokeaha.107.490797
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发表时间：
2008-07-01
期刊：
影响因子：
8.3
通讯作者：
Skoog, Ingmar
中科院分区：
文献类型：
--
作者：
Liebetrau, Martin;Steen, Bertil;Skoog, Ingmar
背景和目的-抑郁可能增加中风的风险。很少有研究调查抑郁症是否会增加老年人和痴呆症患者中风的风险。我们研究了抑郁症在85岁的老年人和3年的发病率首次stroke.Methods -一个有代表性的样本494 85岁的老年人（147痴呆症，347非痴呆症）在哥德堡，瑞典，进行了精神科检查和关键的线人访谈。抑郁症和痴呆症的诊断是根据《精神障碍诊断和统计手册》第三版进行的。对样本进行了为期3年的卒中发生率随访。从瑞典医院出院登记处、死亡证明、自我报告和关键举报人获得卒中信息。那些已知的中风史在基线（n = 93）被排除在发病率study. Results-The抑郁症的患病率在85岁是19%。基线抑郁（风险比，2.7; 95% CI，1.5 - 4.7; P = 0.0006）和收缩压（风险比，1.014/1 mm Hg; 95% CI，1.00 - 1.03; P = 0.019）与随访期间首次卒中发生率增加相关。抑郁症增加痴呆和非痴呆个体中风的风险。在抑郁症状中，在多变量分析中，只有抑郁情绪是首次卒中发病率的独立预测因素。85岁时的中风史与临床抑郁症无关。结论：抑郁症和中风在老年人群中都很常见。抑郁症会增加首次中风的风险，这一发现表明抑郁症的检测和治疗可能对预防中风有意义。
Background and Purpose - Depression may increase the risk for stroke. Few studies have examined whether depression increases the risk for stroke in the very old and among the demented. We examined the relation between depression in 85-year-olds and the 3-year incidence of first-ever stroke.Methods - A representative sample of 494 85-year-olds (147 demented, 347 nondemented) in Gothenburg, Sweden, was examined with psychiatric examinations and key informant interviews. Diagnoses of depression and dementia were made according to the Diagnostic and Statistical Manual of Mental Disorders, Third Revision. The sample was followed for 3 years regarding the incidence of stroke. Information on stroke was obtained from the Swedish Hospital Discharge Register, death certificates, self-reports, and key informants. Those with known stroke history at baseline (n = 93) were excluded from the incidence study.Results - The prevalence of depression at age 85 was 19%. Depression at baseline (hazard ratio, 2.7; 95% CI, 1.5 to 4.7; P = 0.0006) and systolic blood pressure (hazard ratio, 1.014 per 1 mm Hg; 95% CI, 1.00 to 1.03; P = 0.019) were related to increased incidence of first-ever stroke during follow-up. Depression increased stroke risk both among demented and nondemented individuals. Among the symptoms of depression, only depressed mood was an independent predictor of incidence first-ever stroke in multivariate analyses. Stroke history at age 85 was not associated with clinical depression.Conclusions - Depression and stroke are both common in elderly populations. The finding that depression increases risk for first-ever stroke indicates that detection and treatment of depression may have implications for stroke prevention.