Preexisting Depression and Ambulatory Status After Stroke: Florida-Puerto Rico Collaboration to Reduce Stroke Disparities.
Depression
Ethnicity
Outcomes
Stroke and Other Cerebral Vascular Disease (Neuropsychiatric Aspects)
Journal
The Journal of neuropsychiatry and clinical neurosciences
ISSN: 1545-7222
Titre abrégé: J Neuropsychiatry Clin Neurosci
Pays: United States
ID NLM: 8911344
Informations de publication
Date de publication:
2023
2023
Historique:
medline:
24
11
2023
pubmed:
8
5
2023
entrez:
8
5
2023
Statut:
ppublish
Résumé
Stroke is a global public health burden, and therefore it is critical to identify modifiable risk factors to reduce stroke incidence and improve outcomes. Depression is such a risk factor; however, the association between preexisting depression and stroke outcomes, such as independent ambulation, is not well studied, especially among racial-ethnic minority groups. To address this gap in the literature, effects of preexisting depression on ambulatory status at hospital discharge after stroke were evaluated among individuals participating in the racially and ethnically diverse Florida-Puerto Rico Collaboration to Reduce Stroke Disparities project. Data were analyzed from a total of 42,031 ischemic stroke patients, who were independently ambulatory prior to their stroke, after discharge from 84 hospitals between 2014 and 2017. Preexisting depression was confirmed by medical history or antidepressant medication use. Multilevel multivariate logistic regression analyses were used to assess the association of preexisting depression with independent ambulation at hospital discharge. Effects of sex and race-ethnicity on this association were examined. Of 42,031 participants (mean±SD age=70.4±14.2 years; 48% were female; race-ethnicity: 16% Black, 12% Hispanic living in Florida, and 7% Hispanic living in Puerto Rico), 6,379 (15%) had preexisting depression. Compared with participants without depression, those with preexisting depression were older, were more likely to be female and non-Hispanic White, and had a greater burden of vascular risk factors or comorbid conditions. Independent ambulation at hospital discharge was less frequent among women, Black participants, and individuals with vascular risk factors or comorbid conditions. In multivariate models, preexisting depression decreased the likelihood of independent ambulation at discharge (odds ratio=0.88, 95% CI=0.81, 0.97). No interactions were found between preexisting depression and race-ethnicity or sex. Preexisting depression was independently associated with dependent ambulation at hospital discharge after stroke, regardless of sex and race-ethnicity. Treating depression may contribute to primary stroke prevention and could improve ambulatory status at discharge.
Identifiants
pubmed: 37151036
doi: 10.1176/appi.neuropsych.20220211
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
361-367Subventions
Organisme : NINDS NIH HHS
ID : U54 NS081763
Pays : United States
Déclaration de conflit d'intérêts
Dr. Starosciak has served as a consultant to Viz.ai. Dr. Gutierrez has received research salary support from the Florida Department of Health. Dr. Rose has received honoraria for serving as a consultant for or on the speaker’s bureau of Boston Scientific, Chiesi USA, CSL Behring, and Medtronic. The other authors report no financial relationships with commercial interests.