The 5-Item Mental Health Index Predicts the Initial Diagnosis of Nonfatal Stroke in Older Women

Abstract

Relatively little is known about psychosocial risk factors for the onset of stroke. The aim of this paper is to identify independent psychosocial risk factors for subsequent reported new diagnoses of stroke in older women. A prospective cohort study of women initially aged between 70 and 75 years was first surveyed in 1996 and again in 1999. During this interval, from a final sample of 7839 participants, 174 women reported that a doctor had diagnosed them with stroke for the first time. A range of psychosocial risk factors measured in 1996 (life events, Mental Health Index [MHI-5], having a partner, Perceived Stress Scale, Duke Social Support Index, educational attainment, location of residence, feelings of time pressure) were entered into binary logistic regression models to examine which would predict the self-reported new diagnosis of stroke over the 3-year period after adjusting for a range of biomedical risk factors and the frequency of general practitioner visits in 1996. Only the MHI-5 proved to be a significant predictor of self-reported new stroke diagnosis. The MHI-5 remained a significant risk factor (OR 1.61, 95% CI 1.01-2.55, p < 0.05) even after adjusting for a range of other possible risk factors (body mass index, physical activity, alcohol status, diabetes, heart disease, hypertension, nutritional risk) and frequency of general practitioner visits. Poor mental health appears to be a risk factor for the self-reported new diagnosis of stroke in older women. The 5-item MHI may be a useful instrument for researchers investigating the relationship between psychosocial variables and stroke in older women and for clinicians who wish to identify those at risk for stroke.