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Stroke, Depression, and Functional Health Outcomes Among Adults in the Community

Departments of Epidemiology and Psychiatry, College of Physicians and Surgeons of Columbia University, Mailman School of Public Health, Columbia University, New York, New York, rdg66@ columbia.edu

Devangere P. Devanand, MD

Departments of Epidemiology and Psychiatry, College of Physicians and Surgeons of Columbia University, Mailman School of Public Health, Columbia University, New York, New York

The objective was to determine the association between stroke and depression, the co-occurrence of stroke and depression, and functional health outcomes among adults in the US population. Data were drawn from the Midlife Development in the United States Study (MIDUS) (N = 3032), a nationally representative sample of adults age 25 to 74. Multiple logistic regression analyses were used to determine the association between stroke (past 12-month prevalence), depression (past 12-month prevalence), and functional health outcomes (past 12 months) and to determine whether there is an interaction between depression and stroke in predicting impairment in functioning. Almost one third (29.2%) of adults with stroke in the past year also had depression in the past year (odds ratio 3.5, 95% confidence interval 1.4, 8.9). The co-occurrence of stroke and depression was associated with significantly greater limitations in walking and climbing stairs and poorer general physical functioning than that associated with either without the other. There was evidence of interaction between depression and stroke in predicting limitations, specifically with a statistically significant effect in walking short distances (P = .045). These findings are consistent with previous clinical data and extend those data by suggesting that the co-occurrence of depression and stroke is associated with even poorer functional health outcomes, compared with each alone, and that there may be synergism between the two disorders related to this effect.

Key Words: stroke • epidemiology • major depression • functioning

Journal of Geriatric Psychiatry and Neurology, Vol. 21, No. 1, 41-46 (2008)
DOI: 10.1177/0891988707311041


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