Dataset Information

Poststroke fatigue and depression are related to mortality in young adults: a cohort study.

ABSTRACT:

Objectives

To investigate the relationship between poststroke fatigue and depression and subsequent mortality in young ischaemic stroke patients in a population-based study.

Design

A prospective cohort study.

Setting

All surviving young ischaemic stroke patients living in Hordaland County.

Participants

Young ischaemic stroke patients aged 15-50 years at the time of the stroke were invited to a follow-up on an average 6 years after the index stroke. Psychosocial factors and risk factors were registered. Fatigue was self-assessed by the Fatigue Severity Scale (FSS). Depression was measured by Montgomery-Åsberg Depression Rating Scale (MADRS).

Intervention

No intervention was performed.

Primary and secondary outcome measure

Mortality on follow-up.

Results

In total, 190 patients were included. The mean age on follow-up was 48 years and subsequent follow-up period was 12 years. Cox regression analysis showed that mortality was associated with FSS score (p=0.005) after adjusting for age (p=0.06) and sex (p=0.19). Cox regression analysis showed that mortality was associated with MADRS score (p=0.006) after adjusting for age (p=0.10) and sex (p=0.11).

Conclusions

Both fatigue and depression are associated with long-term mortality in young adults with ischaemic stroke. Depression may be linked to higher mortality because of psychosocial factors and unhealthy lifestyles whereas the link between fatigue and mortality is broader including connection to diabetes mellitus, myocardial infarction and psychosocial factors.

SUBMITTER: Naess H

PROVIDER: S-EPMC3612756 | biostudies-literature | 2013 Mar

REPOSITORIES: biostudies-literature

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Publications

Poststroke fatigue and depression are related to mortality in young adults: a cohort study.

Naess Halvor H Nyland Harald H

BMJ open 20130301 3

<h4>Objectives</h4>To investigate the relationship between poststroke fatigue and depression and subsequent mortality in young ischaemic stroke patients in a population-based study.<h4>Design</h4>A prospective cohort study.<h4>Setting</h4>All surviving young ischaemic stroke patients living in Hordaland County.<h4>Participants</h4>Young ischaemic stroke patients aged 15-50 years at the time of the stroke were invited to a follow-up on an average 6 years after the index stroke. Psychosocial facto ...[more]

PMID: 23457330

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Project description:BackgroundYoung adults with depression and evidence of inflammation may represent a high-risk group for cardiometabolic disorders, but studies of cardiometabolic risk in this population are scarce. We aimed to examine: (1) the prevalence of low-grade inflammation in young-adults with depression; (2) cross-sectional and longitudinal associations between cardiometabolic risk factors and depression with or without evidence of inflammation.MethodThe ALSPAC birth cohort participants were assessed for depression and serum high-sensitivity C-Reactive Protein (CRP) levels at age 18, alongside cardiometabolic measures (fasting insulin, fasting plasma glucose, low-density lipoprotein, high-density lipoprotein, triglycerides, smoking, alcohol intake) at age 18 years, and body mass index at ages 9, 13 and 18 years. Low-grade inflammation was defined as CRP>3 mg/L. Multinomial regression was used to examine associations of cardiometabolic markers with depression cases with and without evidence of inflammation. Sensitivity analyses were conducted to examine for interactions between depression, inflammation and cardiometabolic traits.ResultsOut of 2932 participants, 215 met ICD-10 criteria for depressive episode at age 18 years; 23 (10.7 %) had CRP>3 mg/L and 57 (26.5 %) had CRP 1-3 mg/L. Depressive episode with raised CRP (>3 mg/L) was associated with higher triglycerides (adjusted OR = 2.09; 95 % C.I., 1.35-3.24), higher BMI (adjusted OR = 1.13; 95 % C.I., 1.05-1.22) and insulin insensitivity (adjusted OR = 1.12; 95 % C.I., 1.01-1.26), and longitudinally with higher BMI at ages 9 (adjusted OR = 1.27; 95 % C.I., 1.10-1.48) and 13 (adjusted OR = 1.23; 95 % C.I., 1.09-1.38). There was evidence for interaction between BMI and CRP for the risk of depression at age 18 (adjusted OR for the interaction term = 1.56; 95 % C.I. 0.98-2.02) and between CRP and depressive symptoms for the risk of increased BMI at age 18 (adjusted β for the interaction term = 0.05; 95 % C.I. 0.00-0.12).ConclusionsA notable proportion of young adults with depression have evidence of inflammation. These individuals are at increased risk of cardiometabolic disorders. Management of cardiometabolic risk in depressed individuals with evidence of inflammation should form part of routine clinical practice.

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Dataset Information

Poststroke fatigue and depression are related to mortality in young adults: a cohort study.

Objectives

Design

Setting

Participants

Intervention

Primary and secondary outcome measure

Results

Conclusions

Publications

Poststroke fatigue and depression are related to mortality in young adults: a cohort study.

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