Fei Kezhen, Benn Emma K T, Negron Rennie, Arniella Guedy, Tuhrim Stanley, Horowitz Carol R
From the Center for Health Equity and Community Engaged Research (K.F., E.K.T.B., C.R.H.) and Center for Biostatistics (K.F., E.K.T.B.), Icahn School of Medicine, New York, NY; Yale Institute for Network Science, Yale University, New Haven, CT (R.N.); Institute for Family Health, New York, NY (G.A.); Department of Neurology, Icahn School of Medicine, New York, NY (S.T.); and Department of Medicine, Icahn School of Medicine, New York, NY (C.R.H.).
Stroke. 2016 Feb;47(2):512-5. doi: 10.1161/STROKEAHA.115.010292. Epub 2015 Dec 1.
Although poststroke depression is common, racial-ethnic disparities in depression among stroke survivors remain underexplored. Thus, we investigated the relationship between race/ethnicity and depression in a multiracial-ethnic stroke cohort.
Baseline survey data of validated scales of depression and functional status, demographics, comorbidities, and socioeconomic status were used from a recurrent stroke prevention study among community-dwelling urban stroke/transient ischemic attack survivors.
The cohort included 556 participants with a mean age of 64 years. The majorities were black (44%) or latino (42%) and female (60%), had their last stroke/transient ischemic attack nearly 2 years before study enrollment, and lived below the poverty level (58%). Nearly 1 in 2 latinos, 1 in 4 blacks, and 1 in 8 whites were depressed. Multivariate logistic regression showed that survivors who were younger, were female, had ≥3 comorbid conditions, were functionally disabled from stroke, lacked emotional-social support, and who took antidepressants before study entry had higher risk of depression. Time since last stroke/transient ischemic attack did not affect the chance of depression. After adjusting for all above risk factors, latinos had 3× the odds of depression (95% confidence interval: 1.18-6.35) than whites; blacks and whites had similar odds of depression.
This study reveals that latino stroke survivors have a significantly higher prevalence of depression compared with their non-latino counterparts.
尽管卒中后抑郁很常见，但卒中幸存者中抑郁的种族差异仍未得到充分研究。因此，我们在一个多种族-民族卒中队列中调查了种族/民族与抑郁之间的关系。
我们使用了一项针对社区居住的城市卒中/短暂性脑缺血发作幸存者的复发性卒中预防研究中的基线调查数据，这些数据来自经过验证的抑郁量表、功能状态量表、人口统计学、合并症和社会经济状况量表。
该队列包括556名参与者，平均年龄为64岁。大多数参与者为黑人（44%）或拉丁裔（42%），女性占60%，在研究入组前近2年发生过最后一次卒中/短暂性脑缺血发作，且生活在贫困线以下（58%）。近二分之一的拉丁裔、四分之一的黑人以及八分之一白人患有抑郁症。多因素逻辑回归分析显示，年龄较小、女性、合并症≥3种、因卒中导致功能残疾、缺乏情感-社会支持以及在研究入组前服用抗抑郁药的幸存者患抑郁症的风险更高。自最后一次卒中/短暂性脑缺血发作后的时间并未影响患抑郁症的几率。在对所有上述风险因素进行调整后，拉丁裔患抑郁症的几率是白人的3倍（95%置信区间：1.18 - 6.35）；黑人和白人患抑郁症的几率相似。
本研究表明，与非拉丁裔卒中幸存者相比，拉丁裔卒中幸存者抑郁症的患病率显著更高。
