The Association of Depression, Cognitive Impairment Without Dementia, and Dementia With Risk of Ischemic Stroke

Abstract

Objective To determine if depression, cognitive impairment without dementia (CIND), and/or dementia are each independently associated with risk of ischemic stroke and to identify characteristics that could modify these associations. Methods This retrospective-cohort study examined a population-based sample of 7,031 Americans > 50 years old participating in the Health and Retirement Study (HRS) (1998-2008) who consented to have their interviews linked to their Medicare claims. The 8-item Center for Epidemiologic Studies Depression Scale and/or International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) depression diagnoses were used to identify baseline depression. The Modified Telephone Interview for Cognitive Status and/or ICD-9-CM dementia diagnoses were used to identify baseline CIND or dementia. Hospitalizations for ischemic stroke were identified via ICD-9-CM diagnoses. Results After adjusting for demographics, medical comorbidities, and health-risk behaviors, CIND alone (Odds Ratio [OR]: 1.37, 95%CI: 1.11, 1.69) and co-occurring depression and CIND (OR: 1.65, 95%CI: 1.24, 2.18) were independently associated with increased odds of ischemic stroke. Depression alone was not associated with odds of ischemic stroke (OR: 1.11, 95%CI: 0.88, 1.40) in unadjusted analyses. Neither dementia alone (OR: 1.09, 95%CI: 0.82, 1.45) nor co-occurring depression and dementia (OR: 1.25, 95%CI: 0.89, 1.76) were associated with odds of ischemic stroke after adjusting for demographics. Conclusions CIND as well as co-occurring depression and CIND are independently associated with increased risk of ischemic stroke. Individuals with co-occurring depression and CIND represent a high-risk group that may benefit from targeted interventions to prevent stroke.

Personality traits and risk of cognitive impairment and dementia

“…In particular, dementia ascertainment relied on brief cognitive tests instead of the clinical and neuropsychological evaluations used in previous studies (Terracciano et al, 2014; Wilson et al, 2007). However, the validity of these brief assessments of personality and cognitive status had been previously demonstrated (Clark et al, 2013; Crimmins et al, 2011; Davydow et al, 2015; Lachman et al, 1997; Luchetti et al, 2014; Saczynski et al, 2015; Stephan et al, 2016; Sutin et al, 2016), and the magnitude and direction of the associations observed in the HRS were consistent with results of studies that used more in-depth measures of personality and cognitive status (Duberstein et al, 2011; Johansson et al, 2014; Terracciano et al, 2014; Wilson et al, 2005; Wilson et al, 2007). Another limitation was the relatively short follow-up, but studies with longer time frame have found similar results (Johansson et al, 2014; Terracciano et al, 2014).…”

“…Consistent with other HRS-based studies (Clark et al, 2013; Crimmins et al, 2011; Davydow et al, 2015; Saczynski et al, 2015), we classified individual’s cognitive status based on the modified Telephone Interview for Cognitive Status (TICSm), which was administered at baseline and at every 2-year follow-up. The TICSm included measures of short-term memory, working memory, attention, and processing speed.…”

Adaptação e validação discriminante do instrumento Mini Exame do Estado Mental (MEEM) para avaliação neuropsicológica em adultos angolanos com diagnóstico clínico de acidente vascular cerebral (AVC) e epilepsia

“…Os sinais clínicos associam-se à localização e extensão da lesão causada pelo AVC (Cumming et al, 2013 incapacidade funcional e cognitiva e, cerca de um terço desta população desenvolvem transtorno depressivo (Davydow et al, 2015).…”

“…Transtorno depressivo e demência atuam individualmente como fatores de risco em potencial para a ocorrência de AVC (Davydow et al, 2015;Dong et al, 2012). Estudos sugerem que a associação entre depressão e risco para AVC é maior para indivíduos do sexo feminino Jackson CA, et.…”

“…Estudos sugerem que a associação entre depressão e risco para AVC é maior para indivíduos do sexo feminino Jackson CA, et. Al., 2013;Davydow et al,2015). Entretanto, a incidência de AVC é maior no sexo masculino e indivíduos de raça negra (Reeves et al, 2008) Pacientes vítimas de AVC, decorrente de hemorragia ou infarto, são frequentemente acometidos por algum tipo de deficiência, como prejuízos das funções sensitivas, motoras, de equilíbrio e marcha, linguagem como a afasia, além dos déficits cognitivos, como memória, velocidade de processamento reduzido, atenção prejudicada e disfunção executiva (Cumming et al, 2013;Maaijwee et al, 2014).…”