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Published in: BMC Psychiatry 1/2021

Open Access 01-12-2021 | Stroke | Research article

Prospective association between depressive symptoms and stroke risk among middle-aged and older Chinese

Authors: Yimin Cui, Chunsu Zhu, Zhiwei Lian, Xueyan Han, Qian Xiang, Zhenming Liu, Ying Zhou

Published in: BMC Psychiatry | Issue 1/2021

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Abstract

Background

This study aimed to assess the association between baseline symptoms and changes in depressive symptoms and stroke incidents.

Methods

We used data from the Chinese Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. In total, 10,100 individuals aged ≥45 years and without a history of stroke in 2013 were included. Depressive symptoms were measured using the 10-item version of the Center for Epidemiological Studied Depression scale (elevated depressive symptoms cutoff ≥10). Changes of depressive symptoms were assessed by two successive surveys (stable low/no, recent onset, recently remitted, and stable high depressive symptoms). We assessed whether baseline depressive symptoms and changes of them were associated with stroke incidents reported through 2018. Logistic regression analyses adjusted for age, gender, education, marital status and other potential confounders were performed.

Results

For the analysis of baseline depressive symptoms and stroke (n = 10,100), 545 (5.4%) reported stroke incidents in the following 5-year period. Individuals with elevated depressive symptoms in 2013 experienced a markedly higher stroke risk (odds ratio (OR) = 1.53, 95% confidence interval (CI) = 1.28–1.84) compared with those without elevated depressive symptoms. In the analysis of changes in depressive symptoms (n = 8491, 430 (5.1%) stroke events), participants with stable high (OR = 2.01, 95% CI = 1.58–2.56) and recent-onset (OR = 1.39, 95% CI = 1.04–1.85) depressive symptoms presented higher stroke risk compared to those with stable low/no depressive symptoms, while recently remitted symptoms (OR = 1.12, 95% CI = 0.80–1.57) were not associated with stroke risk.

Conclusions

In conclusion, stable high and newly started depressive symptoms were associated with increased stroke risk, whereas the improvement of depressive symptoms was not related to increase in stroke risk, suggesting that stroke risk may be decreased by effective management of depressive symptoms.
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Literature
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go back to reference Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, Li X, Wang L, Wang L, Liu Y, Liu J, Zhang M, Qi J, Yu S, Afshin A, Gakidou E, Glenn S, Krish VS, Miller-Petrie MK, Mountjoy-Venning WC, Mullany EC, Redford SB, Liu H, Naghavi M, Hay SI, Wang L, Murray CJL, Liang X Lancet (London, England) 2019; 394: 1145–1158 2019/06/30. DOI: https://doi.org/10.1016/s0140-6736(19)30427-1. Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, Li X, Wang L, Wang L, Liu Y, Liu J, Zhang M, Qi J, Yu S, Afshin A, Gakidou E, Glenn S, Krish VS, Miller-Petrie MK, Mountjoy-Venning WC, Mullany EC, Redford SB, Liu H, Naghavi M, Hay SI, Wang L, Murray CJL, Liang X Lancet (London, England) 2019; 394: 1145–1158 2019/06/30. DOI: https://​doi.​org/​10.​1016/​s0140-6736(19)30427-1.
Metadata
Title
Prospective association between depressive symptoms and stroke risk among middle-aged and older Chinese
Authors
Yimin Cui
Chunsu Zhu
Zhiwei Lian
Xueyan Han
Qian Xiang
Zhenming Liu
Ying Zhou
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-021-03492-9

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