Abstract 3883: Depression, Fatigue and Lack of Social Network are Risk Factors for Stroke.
Background: Psychosocial factors such as depression, fatigue, and lack of social network have previously been shown to be independent predictors of IHD and total mortality. There is a lack of studies of whether these factors are also predictive of stroke.
Methods: The study population consisted of 9,827 adults free of previous stroke randomly selected from the population of Copenhagen, Denmark, examined in 1991–94 and followed for stroke until 2000. A 17-item scale measured symptoms of depression and fatigue (vital exhaustion, sum-score 0–17). Co-habitation and frequency of contact with parents, children, family members, friends, neighbours and colleagues were registered. Diversity of contacts was explored by summing contacts (score 0–6). Risk of stroke was analysed using Cox Proportional Hazards model.
Results: There were 419 strokes during follow-up. Age- and gender adjusted risk of stroke increased in a dose-response manner reaching a RR of 1.93 (1.36–2.74) for a vital exhaustion sum-score above 9. Persons living alone had higher risk of stroke: RR 1.38 (1.13–1.68). Regular contacts with family members, colleagues and friends but not with neighbours were associated with lower risk of stroke. Variation in social contact was inversely associated with risk of stroke in a dose-dependent manner: Risk decreased 23% (16–28) for each increase in diversity index score of 1 (fig⇓). Results were unaffected by multivariate adjustment for major confounders including smoking, diabetes, hypertension, lipids and physical inactivity.
Conclusion: These data suggest that depressive symptoms, fatigue, and lack of social network convey increased risk of stroke.