Abstract P348: Lower Odds of Post-Stroke Depression Among Hispanics in New York City: Findings From the Stroke Warning Information and Faster Treatment (SWIFT) Study
Introduction: Post-stroke depression (PSD) is common and associated with poor stroke outcomes, lower quality of life, and higher health care costs. Few studies have examined race/ethnic disparities in PSD, with inconsistent findings. Characteristics of social networks - which may differ by race/ethnicity and influence mental health outcomes - have not been investigated as explanations for race/ethnic disparities in PSD.
Hypothesis: Having larger social networks explains the protective effect of Hispanic ethnicity on PSD.
Methods: As part of SWIFT, mild/moderate stroke and TIA patients were prospectively enrolled in an educational intervention aimed at action around acute stroke symptoms. Depressive symptoms were assessed as part of a larger neurological and psychosocial battery in 1,014 individuals hospitalized for stroke/TIA in upper Manhattan using the CES-D scale. CES-D scores ≥ 8 indicated any depression (8-15 = minor depression, ≥ 16 = depression). Both minor depression and depression were assessed given the older age of the study population and consistent evidence that older individuals experience impairing depressive symptoms that often do not meet full depression criteria. Social networks were assessed using respondents’ household composition, categorized as: lives alone, lives with one non-spouse, lives with spouse, and lives with > 1 person. Unadjusted and adjusted multinomial logistic regressions were used to examine the association between race/ethnicity and PSD and the role of household composition in explaining this association.
Results: Almost 60% (596 of 1,014) of patients met criteria for any depression (35% for depression, 24% for minor depression). Twenty-six percent of patients identified as non-Hispanic white, 17% as non-Hispanic black, and 51% as Hispanic (6% identified as “other”). The prevalence of depression and minor depression was lowest in Hispanics compared with non-Hispanic whites and non-Hispanic blacks (depression: 31%, 39%, and 41%, respectively; minor depression: 22%, 30%, 26%, respectively; p<0.001). Hispanics had 0.50 times the odds of depression and minor depression compared with non-Hispanic whites (OR=0.46, 95% CI: 0.30, 0.71 for depression; OR=0.46, 95% CI: 0.29, 0.74 for minor depression), adjusting for age, gender, stroke severity, and education. Including household composition in the model yielded the same result (OR=0.46, 95% CI: 0.30, 0.71 for depression; OR=0.46, 95% CI: 0.28, 0.74 for minor depression).
Conclusions: Hispanic stroke patients had significantly lower odds of PSD compared with non-Hispanic whites. Social networks, characterized by household composition, failed to explain this disparity in PSD. Further research into factors that account for the protective effect of Hispanic ethnicity on PSD would help elucidate effective interventions for reducing PSD and improving outcomes for stroke patients.
Author Disclosures: E. Goldmann: None. E. Roberts: None. N. Parikh: None. H.M. Kuczynski: None. B. Boden-Albala: None.
- © 2015 by American Heart Association, Inc.