%0 Journal Article %J J Am Geriatr Soc %D 2007 %T Depressive symptoms, inflammation, and ischemic stroke in older adults: a prospective analysis in the cardiovascular health study. %A Arbelaez, Jose J %A Ariyo, Abraham A %A Crum, Rosa M %A Fried, Linda P %A Ford, Daniel E %K Aged %K C-Reactive Protein %K Cardiovascular Diseases %K Cerebral Infarction %K Cohort Studies %K Depression %K Female %K Geriatric Assessment %K Humans %K Inflammation %K Kaplan-Meier Estimate %K Longitudinal Studies %K Male %K Multivariate Analysis %K Personality Assessment %K Proportional Hazards Models %K Prospective Studies %K Psychoneuroimmunology %K Risk Factors %K Socioeconomic Factors %K Statistics as Topic %K United States %X

OBJECTIVES: To investigate the mediator role of inflammation in any relationship between depressive symptoms and ischemic stroke.

DESIGN: Longitudinal prospective study.

SETTING: Review of medical records, death certificates, and the Medicare healthcare utilization database for hospitalizations.

PARTICIPANTS: Total of 5,525 elderly men and women aged 65 and older who were prospectively followed from 1989 to 2000 as participants in the Cardiovascular Health Study.

MEASUREMENTS: Depression symptom scores, inflammatory markers.

RESULTS: Greater depressive symptoms were associated with risk of ischemic stroke (unadjusted hazard ratio (HR)=1.32, 95% confidence interval (CI)=1.09-1.59; HR=1.26, 95% CI=1.03-1.54, adjusted for traditional risk factors). When a term for inflammation (C-reactive protein (CRP)) was introduced in the model, the HRs were not appreciably altered (unadjusted HR=1.31, 95% CI=1.08-1.58; adjusted HR=1.25, 95% CI=1.02-1.53), indicating that CRP at baseline was not a mediator in this relationship. In analyses stratified according to CRP levels, a J-shaped relationship between depressive symptoms and stroke was evident in the unadjusted analyses; in the fully adjusted model, only CRP in the highest tertile was associated with a higher risk for stroke in the presence of higher depressive symptoms scores.

CONCLUSION: The analyses from this prospective study provide evidence of a positive association between depressive symptoms and risk of incident stroke. Inflammation, as measured according to CRP at baseline, did not appear to mediate the relationship between depressive symptoms and stroke.

%B J Am Geriatr Soc %V 55 %P 1825-30 %8 2007 Nov %G eng %N 11 %1 https://www.ncbi.nlm.nih.gov/pubmed/17916124?dopt=Abstract %R 10.1111/j.1532-5415.2007.01393.x