Abstract 139: Depression Following Small Vessel Stroke Is Common And More Prevalent In Women
Dymm, B; Goldstein, LB; El Husseini, NK; Bushnell, CD; Koltai, D
Published in: Stroke
Post-stroke depression (PSD) affects about one third of stroke survivors and is associated with poorer quality of life. Little is known about the prevalence and independent risk factors for depression associated with small vessel stroke (SVS).
We conducted a retrospective analysis of a prospective cohort of patients enrolled in the American Stroke Association-Bugher SVS Study, which enrolled 200 patients within 2 years of SVS and 79 controls without stroke history from 2007 to 2012 at four clinical sites. The primary outcome was PHQ-8 dichotomized at (≥10 and <10) with higher scores consistent with PSD. Chi-square test was used to compare the rates of depression between the two groups. Logistic regression was used to evaluate factors associated with depression in patients with SVS adjusted for age, sex, race/ethnicity, NIH Stroke Scale, white matter disease (WMD) burden, Montreal Cognitive Assessment short-form score, and history of diabetes.
The cohort included 161 participants with SVS (excluding 39 due to missing key variables) and 79 controls. Participant characteristics are described in Table 1. The mean time between stroke and depression screening was 74 days. Among participants with SVS, 31.7% (n=51) screened positive for PSD, compared to 6.3% (n=5) of controls, OR= 6.9 (95%CI 2.6-18.0%; p<0.0001). PSD was prevalent in 35.9% of participants with SVS who had good functional outcome (modified Rankin score ≤2). Female sex was the only variable associated with PSD in those with SVS (OR 2.3, 95%CI 1.0-5.2, p=0.041).
In this well-characterized cohort of SVS with mostly mild stroke severity, depression within 3 months of the incident stroke was about 7 times more likely than those without a history of stroke. The extent of WMD was not associated with PSD, suggesting that small vessel disease other than the incident SVS does not account for the increased rates of PSD. Depression following SVS was more prevalent in women.
