scholarly journals Race/ethnic Differences in Post-Stroke Depression (PSD): Findings from the Stroke Warning Information and Faster Treatment (SWIFT) Study

2016 ◽  
Vol 26 (1) ◽  
pp. 1 ◽  
Author(s):  
Emily Goldmann ◽  
Eric T. Roberts ◽  
Nina S. Parikh ◽  
Aaron S. Lord ◽  
Bernadette Boden-Albala
Keyword(s):  
Ethnic Differences ◽  
Multinomial Logistic Regression ◽  
Prospective Trial ◽  
Early Period ◽  
Ethnic Disparities ◽  
Stroke Patients ◽  
Multinomial Logistic Regression Analysis ◽  
Post Stroke ◽  
Post Stroke Depression ◽  
Race Ethnicity

<p><strong>Objectives</strong>: Post-stroke depression (PSD) is common and associated with poor stroke outcomes, but few studies have examined race/ethnic disparities in PSD. Given the paucity of work and inconsistent findings in this important area of research, this study aims to examine race/ethnic differences in depression in a multi-ethnic cohort of stroke patients.</p><p><strong>Design</strong>: Longitudinal.</p><p><strong>Setting</strong>: Prospective trial of a post-stroke educational intervention.</p><p><strong>Patients or Participants</strong>: 1,193 mild/moderate ischemic stroke/TIA patients.</p><p><strong>Main Outcome Measures</strong>: We used the Center for Epidemiologic Studies Depression (CES-D) Scale to assess subthreshold (CES-D score 8-15) and full (CES-D score ≥ 16) depression at one month (“early”) and 12 months (“late”) following stroke. Multinomial logistic regression analysis examined the association between race/ethnicity and early and late PSD separately.</p><p><strong>Results</strong>: The prevalence of subthreshold and full PSD was 22.5% and 32.6% in the early period and 22.0% and 27.4% in the late period, respectively. Hispanics had 40% the odds of early full PSD compared with non-Hispanic Whites after adjusting for other covariates (OR=0.40, 95% CI: 0.22, 0.76). Race/ethnicity was not significantly associated with late PSD.</p><p><strong>Conclusions</strong>: Hispanic stroke patients had half the odds of PSD in early period compared with whites, but no difference was found in the later period. Further studies comparing trajectories of PSD between race/ethnic groups may further our understanding of race/ethnic disparities in PSD and help identify effective interventions. <em>Ethn Dis</em>. 2016;26(1):1-8; doi:10.18865/ed.26.1.1</p>

scholarly journals Correlates of Single Versus Multiple Functional Disabilities Among Aging Americans: Race/Ethnicity and Region of Birth

2020 ◽  
Vol 6 ◽  
pp. 233372142091478
Author(s):  
Ami R. Moore ◽  
Maggie Bohm-Jordan ◽  
Foster Amey ◽  
Elias Mpofu
Keyword(s):  
Functional Disability ◽  
Multinomial Logistic Regression ◽  
Ethnic Disparities ◽  
Multiple Disabilities ◽  
The United States ◽  
Citizenship Status ◽  
Multinomial Logistic Regression Analysis ◽  
Interaction Terms ◽  
Veteran Status ◽  
Race Ethnicity

Background: Significant racial/ethnic disparities exist in the prevalence of functional disability among older Americans. Objective: The study analyzed the odds of older people in the United States experiencing single and multiple disabilities, by race and region of birth. Method: Data came from the American Community Survey (2011–2015). Multinomial logistic regression analysis was used. Results: Region of birth, race/ethnicity, age, citizenship status, duration of stay, sex, marital status, veteran status, educational attainment, poverty status, and class of workers were all significantly associated with reports of either single or multiple disabilities. However, the introduction of the interaction terms for citizenship status by race modified some of the significant results. For instance, being born in Latin America no longer reduced the odds in reports of both single and multiple disabilities. However, compared with Whites and native-born of all races, both Hispanics who were either naturalized or were noncitizens had lower odds of reporting multiple disabilities (27% and 28% lower, respectively), whereas naturalized Hispanics also had significantly reduced odds (22%) for a single disability. Conclusion: These findings add to the disability, race/ethnicity, and place of birth literature.

scholarly journals Morphological and Metabolic Alteration of Cerebellum in Patients with Post-Stroke Depression

2016 ◽  
Vol 40 (3-4) ◽  
pp. 420-430 ◽  
Author(s):  
Ling Zhang ◽  
Rubo Sui ◽  
Lei Zhang ◽  
Zhuang Zhang
Keyword(s):  
Magnetic Resonance ◽  
Depression Scale ◽  
Resonance Spectroscopy ◽  
Hamilton Depression Scale ◽  
Stroke Patients ◽  
1H Mrs ◽  
Post Stroke ◽  
Cont Group ◽  
Post Stroke Depression ◽  
Norm Group

Background: To study morphological and metabolic changes of cerebellum with multimodality magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H-MRS), respective, to explore correlation between cerebellum alteration and severity of depression in patients with post-stroke depression. Methods: 60 subjects, including 40 stroke patients and 20 healthy volunteers were enrolled. Depression of stroke patients was tested by Self-rating Depression Scale (SDS) and Hamilton Depression Scale (HAMD), based on which stroke-patients were grouped into post-stroke depression (PSD group) and without post-stroke depression (CONT group). Results: Volume of cerebellum decreased in PSD group and CONT group compared with healthy volunteer (NORM) group. White matter of cerebellum in PSD group and CONT group was disrupted; such disruption was significantly in PSD group. In addition, there was correlation between cerebellum volume and FA and HDRS scores (P<00.01). The Cho/Cr and Cho/NAA ratios in cerebellum contralateral to stroke lesion in PSD were higher than those in NORM group (P<0.05). Cho/Cr and Cho/NAA ratios in contralateral cerebellum and ratio difference of Cho/Cr in bilateral cerebellum were positively correlated with HAMD scales (P<0.05). Conclusion: Morphologic and metabolic alterations are evident in patients with post-stroke depression, indicating possible involvement of cerebellum in post-stroke-depression occurrence.

Abstract P32: Potential Underuse of Antidepressants in Post Stroke Depression: Data From the AVAIL Registry

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Nada El Husseini ◽  
Daniel T Laskowitz ◽  
Amanda C Guidon ◽  
DaiWai M Olson ◽  
Xin Zhao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Status ◽  
Stroke Recurrence ◽  
Stroke Patients ◽  
Living Situation ◽  
Factors Associated ◽  
Post Stroke ◽  
Depression Status ◽  
Post Stroke Depression ◽  
Antidepressant Use

Background: Post-stroke depression is common, yet little is known about factors associated with antidepressant use in this population Methods: Data from the multicenter, prospective Adherence eValuation After Ischemic stroke-Longitudinal (AVAIL) registry was used to identify patients with post-stroke depression and to describe factors associated with antidepressant use. The analysis was performed after 3 months in 1751 ischemic stroke patients who had been admitted to 97 hospitals nationwide; 12 month follow-up was available for 1637 patients. The Get with the Guidelines-Stroke database was used to collect baseline data. Patients were classified as depressed based on a self-report scale (the Patient Health Questionnaire-8; score range 0 to 24, score ≥10 indicating depression). Frequencies were compared with Pearson X 2 and unadjusted ORs were calculated. Results: The prevalence of post stroke depression was similar at 3 and 12 months (19% [331/1751] vs 17% [280/1637], respectively, p=0.17). Regardless of depression status, antidepressant use was higher at 12 months (16% [287/1751] vs 20% [334/1637], p=0.002). Antidepressant use was also higher at 12 months in depressed patients (25% [84/331] vs 35% [98/280], p=0.009). The odds of antidepressant use at 3 months was higher in women than men (OR 1.6, 95% CI 1.2-2.1), Whites vs. Blacks (OR 1.7, 95% CI 1.1-2.8), in patients with vs. without cognitive deficits (OR 1.6, 95% CI 1.2-2.1) and in those with more severe disabilities (mRS≥3 vs. mRS<3, OR 1.7, 95% CI 1.3-2.3). Use did not vary with educational level, marital status, living situation, medication insurance coverage, or stroke recurrence. Similar trends were present at 12 months, except with higher use in those with recurrent stroke or TIA (OR 2.1, 95% CI 1.4-3.1). Conclusion: Three-quarters of depressed stroke patients at 3-months and nearly two-thirds at 12 months were not receiving antidepressants. Regardless of depression status, utilization of antidepressants after 3 and 12 months varied based on gender, race/ethnicity, cognitive status, disability level, and after 12-months, stroke recurrence. The reasons for the apparent underuse of antidepressants in patients with prevalent post-stroke depression require further study.

scholarly journals LACK OF EMPHASIS ON PSYCHOLOGICAL REHABILITATION FOR STROKE PATIENTS

2012 ◽  
Vol 1 (1) ◽  
pp. 2
Author(s):  
Samina Masood Haider
Keyword(s):  
Emotional Difficulties ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Post Stroke ◽  
Post Stroke Depression ◽  
The Many ◽  
Over Time

It has been observed that most of the patients are not aware of the dilapidating affects of post stroke depression on their recovery, survival and a return to normal activities of life. The lack of emphasis on psychological rehabilitation for stroke patients is a source of concern for me and I would like to bring to your attention about the facts regarding the implications of proper psychological rehabilitation is not undertaken. Stroke survivors report a range of emotional difficulties, most common being fear, anxiety, frustration, anger, sadness and a sense of grief for their physical and mental losses. Usually these feelings may fade over time however, some patients may struggle with adjusting to the many changes following stroke. When this happens these feelings can develop into depression. It is estimated that approximately one-third of stroke1 survivors develop post-stroke depression (PSD)

Benefits of antidepressant treatment after a stroke

2017 ◽  
Vol 41 (S1) ◽  
pp. S315-S315 ◽  
Author(s):  
O. Zerriaa ◽  
O. Moula ◽  
S. Ben Saadi ◽  
I. Jelalia ◽  
R. Ghachem
Keyword(s):  
Functional Recovery ◽  
Cognitive Skills ◽  
Antidepressant Treatment ◽  
Antidepressant Drugs ◽  
Antidepressant Therapy ◽  
Motor Deficit ◽  
Stroke Patients ◽  
Double Blind ◽  
Post Stroke ◽  
Post Stroke Depression

IntroductionStroke is an important cause of morbidity and is responsible for 9% of all deaths worldwide. The most frequent neuropsychiatric consequence of stroke is post-stroke depression (PSD). It has been shown to be associated with both impaired recovery and increased mortality. The aim of our study is to determine the benefits of antidepressant prescription after a stroke.MethodThe databases from Medline and PubMed were reviewed for articles related to post-stroke depression (PSD), antidepressant treatment and stroke, post-stroke depression and functional recovery, stroke related impairment.ResultsAntidepressant drugs have been shown to be effective in treating PSD in six double blind randomized studies. Patients treated with antidepressants had better recovery from disability than patients who did not receive antidepressant therapy: it was proved that antidepressant drugs cause an improvement in cognitive skills and functional recovery in PSD patients. In patients with ischemic stroke and moderate to severe motor deficit, the early prescription of fluoxetine with physiotherapy enhanced motor recovery after 3 months. Some studies showed that PSD can be effectively prevented: nortriptyline, fluoxetine, milnacipran and sertraline appeared to be efficacious in preventing depression after stroke and are to use without significant adverse effects in stroke patients.ConclusionAntidepressant treatment plays an increasing role in the management of patients with acute stroke. Therefore, early initiation of antidepressant therapy, in non-depressed stroke patients, may reduce the odds for development of PSD, and improve cognitive and functional recovery.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Association among depression, cognitive impairment and executive dysfunction after stroke

2012 ◽  
Vol 6 (3) ◽  
pp. 152-157 ◽  
Author(s):  
Luisa Terroni ◽  
Matildes F.M. Sobreiro ◽  
Adriana B. Conforto ◽  
Carla C. Adda ◽  
Valeri D. Guajardo ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Neuropsychological Tests ◽  
Executive Dysfunction ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Adequate Treatment ◽  
Post Stroke ◽  
Quantitative Studies ◽  
Post Stroke Depression ◽  
The Relationship

ABSTRACT The relationship between depression and cognitive impairment, frequent after stroke, is complex and has not been sufficiently elucidated. Objective: To review the relationship between post-stroke depression and cognitive impairment. Methods: We performed a PubMed database search spanning the last ten years, using the terms post-stroke depression, cognitive dysfunction, cognitive impairment and neuropsychological tests. Our target studies were original quantitative studies that investigated the relationship between post-stroke depression (PSD) and cognitive impairment in stroke patients. Articles published in English, Spanish, Italian and Portuguese were considered. Selection criteria were the use of neuropsychological tests to assess cognitive function, and of either instruments to diagnose major depression, or scales to assess depressive symptoms, within the first three months after stroke. Results: Six original quantitative studies fulfilled the criteria. The prevalence of PSD within the first three months after stroke ranged from 22% to 31%. Incidence ranged from 25% to 27% and was evaluated in only two studies. PSD was associated with increased cognitive impairment. Cognitive impairment was reported in 35.2% to 87% of the patients. Post-stroke cognitive deficits were reported mostly in executive function, memory, language, and speed of processing. Conclusion: Executive dysfunction and depression occur in stroke survivors, are frequently coexistent, and also associated with worse stroke prognosis. Healthcare professionals need to address and provide adequate treatment for depression and executive dysfunctions in stroke patients early in the first three months after stroke. Future studies should evaluate the efficacy of programs evaluating the early detection and treatment of PSD and executive dysfunction in stroke survivors.

Abstract 118: Predictors of Post-Stroke Depression in Ischemic Stroke Patients using the Patient Health Questionnaire-9

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Lauren E Fournier ◽  
Xu Zhang ◽  
Esther Bonojo ◽  
Mary Love ◽  
Jennifer Sanner ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Stroke Patients ◽  
Post Stroke ◽  
Patient Health ◽  
Post Stroke Depression

scholarly journals 0377 A Strengths-Based Approach to Examine Obstructive Sleep Apnea in Black and White Patients

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A144-A145
Author(s):  
N J Williams ◽  
M Butler ◽  
J Roseus ◽  
J Blanc ◽  
A Barnes ◽  
...  
Keyword(s):  
Social Support ◽  
Ethnic Differences ◽  
Ethnic Disparities ◽  
Sleep Diary ◽  
Newly Diagnosed ◽  
Linear Regression Models ◽  
Obstructive Sleep ◽  
Falling Asleep ◽  
Race Ethnicity ◽  
Insomnia Complaints

Abstract Introduction The majority of studies on race/ethnic disparities in OSA are derived from a deficit-based perspective (i.e. &gt;BMI, non-adherence to PAP). It would prove useful to identify which aspects are protective to inform potential treatment approaches. We focused on two potential factors: resilience and social support, in patients newly diagnosed with OSA. Given the high prevalence of insomnia complaints in patients with OSA, insomnia was our outcome of interest. Methods 91 patients newly diagnosed with OSA provided demographic and socioeconomic status, sleep measures (Epworth, DBAS), resilience (Connor Davidson Resiliency Scale), social support (MOS Social Support Scale) and completed the Insomnia Severity Index. The cross-sectional associations between ISI, race/ethnicity, resilience, social support and their interaction effects were examined using linear regression models with covariate adjustment for participant age, sex and BMI. We ascertained total ISI score and individual items. Results The sample was 34.1% black (n=31), mean age of 57.6 years, SD=13.6, 64.8% male (n=59), and mean BMI of 32.4, SD=7.04. Mean sleep duration (as reported by sleep diary) was 6.64, SD=1.35. Black, white differences were not observed for sleepiness (M=8.60; 10.43, p=0.11) or DBAS (M=4.61; M=5.04, p=0.30). Blacks, reported clinically significant insomnia (M=15.00, SD=7.17) compared to whites (M=12.02, SD=6.83, p=0.05). On the individual ISI items, blacks were significantly more likely to endorse difficulty falling asleep (M=1.58, SD=1.54; M=0.75, SD=0.93,p=0.002) and waking up too early (M=2.09, SD=1.26; M=1.45, SD=0.93,p=0.021) compared to whites. Resilience (M=30.04, SD=6.42) and social support scores (M=74.13, SD=21.36) did not differ by race/ethnicity. In adjusted linear analysis, resilience had significant effect on ISI score (b=-0.36, SE=0.12, p=0.003) but not social support (b=-0.06, SE=0.08, p=0.31). Conclusion In this study we did not observe race/ethnic differences for sleepiness and dysfunctional beliefs about sleep. With respect to the protective factors, race/ethnic differences were not observed. Resilience, not social support, was related to insomnia complaints. Future studies should examine a variety of factors that may serve black and other racial/ethnic groups with OSA, and help elucidate protective processes. Support K23HL125939

scholarly journals Serum lipid profiles and post-stroke depression in acute ischemic stroke patients

2019 ◽  
Vol Volume 15 ◽  
pp. 1573-1583 ◽  
Author(s):  
Huiping Shen ◽  
Xinjie Tu ◽  
Xiaoqian Luan ◽  
Yaying Zeng ◽  
Jincai He ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Serum Lipid ◽  
Lipid Profiles ◽  
Stroke Patients ◽  
Post Stroke ◽  
Post Stroke Depression

scholarly journals Depression and functional disability in stroke patients

2020 ◽  
Author(s):  
Puji Astuti ◽  
Kusnanto ◽  
Ferra Dwi Novitasari
Keyword(s):  
Functional Disability ◽  
Recovery Process ◽  
Simple Random Sampling ◽  
Observational Research ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Post Stroke ◽  
Post Stroke Depression ◽  
Design And Methods ◽  
Depressive Episodes

Background: Stroke patients often suffer from depression, a mental disorder that worsens their condition and slows down the recovery process. Depression is the leading cause of functional disability due to inability to cope with daily stressors and to function independently in their activities. The purpose of this study is to analyze the relationship between depression and functional disability levels in post-stroke patients. Design and Methods: This is an analytic observational research with a cross-sectional approach. The population in exam consisted of all 4-12 week post-stroke patient in the hospital (about 139 patients). The study focused on 104 respondents, who were selected using simple random sampling techniques. Results: The results show that 62.5% stroke patients suffered mild depressive episodes after the stroke while 58.7% experienced mild disabilities. Analysis results using the Pearson Product Moment Test obtained P=0,000. This shows there is a relationship between the level of depression and the degree of functional disability in post-stroke patients. Conclusions: It can be concluded that there is a significant relationship between the levels of post-stroke depression and the functional disability. Families are expected to provide a safe, supportive, and comfortable environment to lessen the level of depression.

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