Prevalence, Predictors, and Prognosis of Depression After Transient Ischemic Attack: A Population-Based Study

Area of Science:

• Neurology
• Psychiatry
• Epidemiology

Background:

• Depression is a frequent complication following stroke, linked to higher mortality rates.
• Limited data exist on the prevalence, predictors, and prognosis of depression after transient ischemic attack (TIA).
• Post-TIA depression may stem from brain lesions, disability, shared risk factors, or anxiety about stroke recurrence.

Purpose of the Study:

• To assess the prevalence, predictors, and 5-year prognosis of depression in a population-based cohort following TIA.
• To investigate the association between depression and risk factors, disability, quality of life, institutionalization, recurrent vascular events, and mortality.

Main Methods:

• A population-based cohort (OXVASC) assessed depression prevalence at 1 and 12 months post-TIA (2014-2020).
• Multivariable logistic regression identified depression predictors, including risk factors and brain imaging findings.
• Cox proportional hazard regression analyzed the 5-year outcome associations, adjusting for significant covariates.

Main Results:

• Depression was diagnosed in 24.3% of 519 TIA patients, with higher prevalence at 1 month (20.7%) versus 12 months (14.9%).
• Independent predictors of depression included younger age, low baseline mood, prior depression, multimorbidity, living alone, disability, and deprivation.
• Depression did not predict recurrent vascular events but significantly predicted increased 5-year all-cause mortality (aHR, 2.27), especially when persistent (aHR, 4.58).
• Persistent depression was also linked to increased disability (aOR, 12.10), institutionalization (aHR, 5.83), and reduced quality of life (coefficient, -0.245).

Conclusions:

• Depression is common early after TIA, irrespective of acute ischemic lesions on brain imaging.
• Persistent depression following TIA is a significant predictor of adverse outcomes, including increased mortality, disability, and reduced quality of life.