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Depressive symptoms, inflammation, and ischemic stroke in older adults: a prospective analysis in the cardiovascular health study.
Tuesday,2012-11-06 12:09 America/Los_Angeles — eenright
| Title | Depressive symptoms, inflammation, and ischemic stroke in older adults: a prospective analysis in the cardiovascular health study. |
| Publication Type | Journal Article |
| Year of Publication | 2007 |
| Authors | Arbelaez, JJ, Ariyo, AA, Crum, RM, Fried, LP, Ford, DE |
| Journal | J Am Geriatr Soc |
| Volume | 55 |
| Issue | 11 |
| Pagination | 1825-30 |
| Date Published | 2007 Nov |
| ISSN | 1532-5415 |
| Keywords | Aged, C-Reactive Protein, Cardiovascular Diseases, Cerebral Infarction, Cohort Studies, Depression, Female, Geriatric Assessment, Humans, Inflammation, Kaplan-Meier Estimate, Longitudinal Studies, Male, Multivariate Analysis, Personality Assessment, Proportional Hazards Models, Prospective Studies, Psychoneuroimmunology, Risk Factors, Socioeconomic Factors, Statistics as Topic, United States |
| Abstract | <p><b>OBJECTIVES: </b>To investigate the mediator role of inflammation in any relationship between depressive symptoms and ischemic stroke.</p><p><b>DESIGN: </b>Longitudinal prospective study.</p><p><b>SETTING: </b>Review of medical records, death certificates, and the Medicare healthcare utilization database for hospitalizations.</p><p><b>PARTICIPANTS: </b>Total of 5,525 elderly men and women aged 65 and older who were prospectively followed from 1989 to 2000 as participants in the Cardiovascular Health Study.</p><p><b>MEASUREMENTS: </b>Depression symptom scores, inflammatory markers.</p><p><b>RESULTS: </b>Greater depressive symptoms were associated with risk of ischemic stroke (unadjusted hazard ratio (HR)=1.32, 95% confidence interval (CI)=1.09-1.59; HR=1.26, 95% CI=1.03-1.54, adjusted for traditional risk factors). When a term for inflammation (C-reactive protein (CRP)) was introduced in the model, the HRs were not appreciably altered (unadjusted HR=1.31, 95% CI=1.08-1.58; adjusted HR=1.25, 95% CI=1.02-1.53), indicating that CRP at baseline was not a mediator in this relationship. In analyses stratified according to CRP levels, a J-shaped relationship between depressive symptoms and stroke was evident in the unadjusted analyses; in the fully adjusted model, only CRP in the highest tertile was associated with a higher risk for stroke in the presence of higher depressive symptoms scores.</p><p><b>CONCLUSION: </b>The analyses from this prospective study provide evidence of a positive association between depressive symptoms and risk of incident stroke. Inflammation, as measured according to CRP at baseline, did not appear to mediate the relationship between depressive symptoms and stroke.</p> |
| DOI | 10.1111/j.1532-5415.2007.01393.x |
| Alternate Journal | J Am Geriatr Soc |
| PubMed ID | 17916124 |
| Grant List | N01 HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States |