Abstract 21072: Depressive Symptoms and Incident Stroke in Hispanic, African-American, and White Older Americans
Although depressive symptoms have been implicated as a risk factor for stroke, most research has been conducted in predominantly white samples. We assessed whether the association between elevated depressive symptoms and incident stroke is the same for whites and racial/ethnic minorities in a diverse sample of Americans age 50+.
Methods: Depressive symptoms were assessed at enrollment for 19,085 stroke-free Health and Retirement Study participants, including 2,634 blacks and 1,344 Hispanics. Respondents were followed an average of 8.1 years for first self- or proxy-report of a stroke (1,863 events). Scores of 3+ on an 8-item Centers for the Epidemiologic Study of Depression scale were considered “elevated depressive symptoms.” We estimated hazard ratios (HRs) for stroke onset using Cox proportional hazards models, adjusting for sociodemographic risk factors (age, sex, southern birthplace, parental education, own education, household income and wealth, and marital status) in models stratified by race/ethnicity. We also tested the interaction of race/ethnicity and baseline elevated depressive symptoms in pooled models.
Results: Prevalence of elevated depressive symptoms was higher in blacks (27%) and Hispanics (33%) than non-Hispanic whites (18%). Elevated depressive symptoms predicted stroke risk in whites (HR=1.45; 95% CI: 1.28, 1.64). Hazard ratios were elevated but only marginally statistically significant (p<0.10) for blacks (HR=1.24; 95% CI: 0.97, 1.96) and Hispanics (HR=1.40; 95% CI: 0.95, 2.08). Interaction terms were not statistically significant for blacks (p=0.15) or Hispanics (p=0.54).
Conclusions/relevance: Depressive symptoms predict incident stroke risk in whites, blacks, and Hispanics. We find no evidence that the effect of this psychosocial risk factor is modified by race or ethnicity, but racial/ethnic minorities were more likely to report elevated depressive symptoms in this sample.
- © 2010 by American Heart Association, Inc.