Depression and Diabetes Mellitus Multimorbidity Is Associated With Loss of Independence and Dementia Poststroke

Ouk, Michael; Wu, Che‐Yuan; Colby-Milley, Jessica; Fang, Jiming; Zhou, Limei; Shah, Baiju R.; Herrmann, Nathan; Lanctôt, Krista L.; Linkewich, Elizabeth; Law, Marcus; Swartz, Richard H.; Kapral, Moira K.; Black, Sandra E.; MacIntosh, Bradley J.; Edwards, Jodi D.; Swardfager, Walter

doi:10.1161/strokeaha.120.031068

Cited by 13 publications

(15 citation statements)

References 42 publications

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“…As previously reported, mental disorders, psychological distress, and the consumption of psychoactive drugs were associated with the presence of several comorbid chronic diseases in our study [ 17 , 40 , 41 , 42 ]. Fisher et al [ 17 ] concluded that, in people with DM, having more concomitant chronic comorbidities was significantly associated with a higher risk of suffering DM distress, anxiety, and depressive symptoms.…”

Section: Discussionsupporting

confidence: 81%

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Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case–Controlled Study

López-Herránz

Jiménez‐García

et al. 2021

IJERPH

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Background: The purpose of this study was to assess and compare the prevalence of self-reported mental disorders, psychological distress, and psychotropic drug consumption among people with diabetes mellitus (DM) and matched non-DM controls. Methods: A case–controlled study using data from the Spanish National Health Interview Survey was conducted in 2017. We identified 2116 DM adults (aged ≥35 years). Non-DM controls were matched 1:1 by age, sex, and province of residence. Results: Prevalence of mental disorders (25.0% vs. 19.2%; p < 0.001), psychological distress (29% vs. 19.5%; p < 0.001), and consumption of psychiatric medications (29.7% vs. 23.5%; p < 0.001) among DM cases were higher than those among matched non-DM controls. The DM patient variables associated with experiencing a mental disorder, psychological distress, and consumption of psychiatric medications were: being a woman, worse self-rated health, and a visit to a psychologist within the last year. Older age (≥80 years) was associated with a lower probability of reporting mental disorders and psychological distress among DM cases. Not practicing physical exercise was significantly associated with experiencing psychological distress. Conclusions: Adults with DM included in our investigation have a significantly higher prevalence of mental disorders, psychological distress, and consumption of psychiatric medications than non-DM controls. It is necessary to implement screening strategies and psychological interventions to improve the mental health of DM patients in Spain, focusing especially on women and those aged 35 to 59 years.

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Section: Discussionsupporting

confidence: 81%

“…Associations between DM or post-stroke depression and post-stroke dementia are well documented. Recently, Ouk et al concluded that premorbid depression and DM are risk factors for developing dementia in the years after a stroke [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case–Controlled Study

López-Herránz

Jiménez‐García

et al. 2021

IJERPH

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“…In addition to higher utilization, survival bias might also play an important role in the longitudinal investigation assessment, and hence achieving a higher coexistence with multimorbidity. Moreover, the association between depression and diabetes was significantly proven in current studies ( 55 , 56 ), better knowledge of the pathogen mechanisms needing to identify allows a more effective tailored care.…”

Section: Discussionmentioning

confidence: 96%

Spatiotemporal Analysis of the Prevalence and Pattern of Multimorbidity in Older Chinese Adults

et al. 2022

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BackgroundMultimorbidity presents an enormous problem to societal and healthcare utilization under the context of aging population in low- and middle-income countries (LMICs). Currently, systematic studies on the profile of multimorbidity and its characteristics among Chinese elderly are lacking. We described the temporal and spatial trends in the prevalence of multimorbidity and explored chronological changes of comorbidity patterns in a large elderly population survey.MethodsData were extracted from the Chinese Longitudinal Healthy Longevity Study (CLHLS) conducted between 1998 and 2018 in a random selection of half of the counties and city districts. All the elderly aged 65 and older were included in the survey of eight waves. We used 13 investigated chronic diseases to measure the prevalence of multimorbidity by means of geography, subpopulation, and chronological changes. The patterns of multimorbidity were assessed by computing the value of relative risk (RR indicates the likelihood of certain diseases to be associated with multimorbidity) and the observed-to-expected ratio (O/E indicates the likelihood of the coexistence of a multimorbidity combination).ResultsFrom 1998 to 2018, the prevalence of multimorbidity went from 15.60 to 30.76%, increasing in the fluctuation across the survey of eight waves (pfor trend = 0.020). Increasing trends were observed similarly in a different gender group (pmale = 0.009; pfemale = 0.004) and age groups among female participants (p~80 = 0.009; p81−90 = 0.004; p91−100 = 0.035; p101~ = 0.018). The gap in the prevalence of multimorbidity between the north and the south was getting narrow across the survey of eight waves. Hypertension was the highest prevalent chronic condition while diabetes was most likely to coexist with other chronic conditions in the CLHLS survey. The most frequently occurring clusters were hypertension and heart disease, hypertension and cataract, and hypertension and chronic lung disease. And, the cancer, TB, and Parkinson's disease cluster took the domination of O/E rankings over time, which had a higher probability of coexistence in all the multimorbidity combinations.ConclusionsThe prevalence of multimorbidity has been increasing nationwide, and more attention should be paid to a rapid growth in the southern part of China. It demands the effective diagnosis and treatment adopted to the highly prevalent comorbidities, and strategies and measures were adjusted to strongly relevant clusters.

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“…As a result, we found a slight advantage of improving neurological recovery in the cilostazol-based group, though there was no statistical significance. In addition, our findings demonstrated a high proportion of patients with diabetes, which had been shown to be associated with stroke and poor post-stroke outcomes [31][32][33] . At the same time, previous studies suggested that cilostazol is beneficial to attenuate the progression of coronary atherosclerosis in patients with diabetes [33][34][35] .…”

Section: Discussionmentioning

confidence: 55%

Comparison of Cilostazol versus Clopidogrel in Addition to Aspirin in Patients with Ischemic Stroke who Underwent Intracranial or Extracranial Artery Stent Implantation

Liu

Shao

Yang

et al. 2023

JAT

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Aims:The role of cilostazol after intracranial or extracranial artery stent implantation is still unclear. Therefore, we designed this trial to explore the efficacy and safety of cilostazol in this particular population. Methods:In this retrospective study, patients were divided into the cilostazol or clopidogrel group by the antiplatelet therapy received after artery stent implantation. The primary efficacy endpoint was ischemic stroke. Bleeding events and other antiplatelet drug-related adverse reactions (ADRs) were also recorded. Neurological function prognosis was evaluated by the modified Rankin Scale (mRS) after discharge.Results: A total of 156 patients were enrolled; 56 underwent intracranial artery stenting, 95 underwent extracranial artery stenting, and 5 underwent intracranial combined with extracranial artery stenting. Any stroke and bleeding events in the hospital of the two groups were comparable (P=0.38, P=0.34, respectively). The incidence of stroke recurrence tended to be lower in the cilostazol group, although not significant (cilostazol vs. clopidogrel, 1.35% vs. 4.88%, P=0.25). There was a significant difference of any bleeding events between the two groups (cilostazol vs. clopidogrel, 5.41% vs. 20.73%, P=0.02). During follow-up, we did not observe an apparent increase of ADRs in the cilostazol group (cilostazol vs. clopidogrel, palpitation 4.05% vs. 2.44%, P=0.58; gastrointestinal discomfort events 8.11% vs. 12.20%, P=0.80). There were no differences between the two groups of neurological function prognosis (P=0.29). Conclusions:Cilostazol-based dual antiplatelet therapy could be recommended as an effective and safe therapy regimen among patients undergoing intracranial or extracranial artery stent implantation.

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Depression and Diabetes Mellitus Multimorbidity Is Associated With Loss of Independence and Dementia Poststroke

Cited by 13 publications

References 42 publications

Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case–Controlled Study

Mental Health among Spanish Adults with Diabetes: Findings from a Population-Based Case–Controlled Study

Spatiotemporal Analysis of the Prevalence and Pattern of Multimorbidity in Older Chinese Adults

Comparison of Cilostazol versus Clopidogrel in Addition to Aspirin in Patients with Ischemic Stroke who Underwent Intracranial or Extracranial Artery Stent Implantation

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