Abstract WP203: Frequency of Post-stroke Depression Among Hypertensive Black and Hispanic Stroke Survivors

Abstract

Introduction: Post-stroke depression (PSD) is estimated to affect one-third of stroke survivors and is associated with long-term disability but scarce data exist in minority populations. This analysis examined the frequency and correlates of PSD in a cohort of Black and Hispanic stroke survivors. Methods: We analyzed baseline data from an ongoing clinical trial comprising 450 Blacks and Hispanics with recent stroke from New York City stroke centers. Participants were interviewed at baseline to assess depressive symptoms using the Patient Reported Outcomes Measurement Information System (PROMIS) Depression Measure. PSD was defined as a PROMIS score ≥55 indicating at least mild depression. Other data collected included demographics, clinical factors, health-related quality of life, functional independence (Barthel Index), stroke-related disability and executive functioning (Frontal Assessment Battery). Results: Data was available for 209 Hispanics and 202 Blacks. The sample was 44% female with average age 61.7±11.1 years. Socioeconomic status was low with 72.6% of participants having annual income <$25,000 and 49.3% having less than high school education. PSD was identified in 32.4% of the sample. In bivariate analyses, participants with vs. without PSD were more likely to be female (54.2% vs. 39.2%, p=.003), on disability (44.0% vs. 25.9%, p<.001) and have annual income <$25,000 (81.6% vs 68.3%, p=.011). Participants with vs. without PSD also had lower baseline systolic BP (146.6±12.0 vs. 150.4±15.9, p=.005), were more likely to have ≥3 comorbid conditions (39.6% vs. 26.3%, p=.014), and had worse scores on all measures of physical disability, functional independence, cognitive function and quality of life (p≤.01). In multivariate analysis, PSD was associated with younger age, lower quality of life and not being married (p<.05). In addition, foreign-born participants were more likely than US-born participants to have PSD (OR=3.34, 95% CI=1.40-7.97, p=.006). Conclusions: PSD was common in this cohort of minority stroke survivors and was associated with cognitive and physical disability. The finding of a higher rate in foreign-born survivors is novel and warrants further research regarding long-term effects of PSD in this population.