Abstract
Background: Stroke remains one of the leading causes of mortality and long-term disability worldwide. This study aims to investigate the association between having a history of stroke and depression severity among adults with depression.
Methods: Adults (18 and older) with depression from the 2005-2018 National Health and Nutrition Examination Surveys (NHANES) were included in this study. Statistical analyses with a two-sample t-test for means, a chi-square test for association, and univariable and multivariable binary logistic regression models were employed to scrutinize potential sociodemographic characteristics for self-reported having a history of stroke among adults with depression. Sociodemographic characteristics included age, gender, race, educational level, marital status, high-density lipoprotein (HDL) categories, body mass index (BMI) categories, diabetes status, medical insurance, poverty income ratio (PIR), depression severity, trouble sleeping, hypertension, smoking status, and alcohol use.
Results: There were 1388 adults with depression, and 106 (6.03%) reported a history of stroke. In the univariable analysis, among adults with depression, severe level of depression, diabetes, educational level more than high school, married/living with partner, widowed/divorced/separated, having trouble sleeping, medical insurance, and hypertension were significantly associated with having a history of stroke. However, only medical insurance remained statistically significant after adjusting for potential confounders in the multivariable model.
Conclusions: A key finding was the strong association between medical insurance and stroke history among individuals with depression in all the models. This may reflect greater access to healthcare and increased diagnosis rather than a direct causal relationship. Given the study's sample size limitations, larger, more representative studies are needed to investigate these relationships further.
Keywords: Stroke, Depression, Sociodemographic Characteristics, NHANES