Stroke：抑郁是中年女性卒中的强危险因子

　　澳大利亚一项研究表明，抑郁是中年女性卒中的强危险因子，相关论文5月16日在线发表于《卒中》（Stroke）杂志。

　　该研究共纳入平均年龄为52.5岁的10 547例受试者。自1998年开始接受调查问卷且之后的12年间进行每3年一次的随访。以每次调查应用流行病学研究抑郁量表（精简版）且在过去几个月中应用抗抑郁药物定义为抑郁。通过自我记录和死亡率数据确定卒中。

　　结果显示，在每项调查中抑郁的患病率约为24% 。在随访期间卒中发生177例。抑郁与卒中发生率增加2倍相关[比值比（OR）为2.41；95置信区间为1.78–3.27]，在校正年龄、社会人口统计学因素、生活方式和生理因素后上述相关性有所减弱。

Depression and Risk of Stroke in Midaged Women
Background and Purpose
Depression is known to increase stroke risk. Although limited, there is some evidence for age differences, with a suggestion for a stronger association in younger groups. We investigated the effect of depression on stroke incidence in a large cohort of midaged women.
Methods
We included 10 547 women without a history of stroke aged 47 to 52 years from the Australian Longitudinal Study on Women’s Health, surveyed every 3 years from 1998 to 2010. Depression was defined at each survey using the Center for Epidemiological Studies Depression Scale (shortened version) and antidepressant use in the past month. Stroke was ascertained through self-report and mortality data. We determined the association between depression and stroke at the subsequent survey, using generalized estimating equation analysis, adjusting for time-varying covariates.
Results
At each survey, ≈24% were defined as having depression. During follow-up, 177 strokes occurred. Depression was associated with a >2-fold increased odds of stroke (odds ratio, 2.41; 95% confidence interval, 1.78–3.27), which attenuated after adjusting for age, socioeconomic status, lifestyle, and physiological factors (odds ratio, 1.94; 95% confidence interval, 1.37–2.74). Findings were robust to sensitivity analyses addressing methodological issues, including definition of depression, antidepressant use, and missing covariate data.
Conclusions
Depression is a strong risk factor for stroke in midaged women, with the association partially explained by lifestyle and physiological factors. Further studies of midaged and older women from the same population are needed to confirm whether depression is particularly important in younger women and to inform targeted intervention approaches.