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Multicenter Study
. 2022 Jan;35(1):121-127.
doi: 10.1177/0891988720968274. Epub 2020 Oct 19.

Pre-Stroke Depression in Ghana and Nigeria: Prevalence, Predictors and Association With Poststroke Depression

Akin Ojagbemi  1 , Joshua Akinyemi  1 , Kolawole Wahab  2 , Lukman Owolabi  3 , Oyedunni Arulogun  1 , Josephine Akpalu  4 , Albert Akpalu  4 , Godwin Ogbole  1 , Cynthia Akinsanya  5 , Adeniyi Wasiu  6 , Moyinoluwa Tito-Ilori  1 , Fakunle Adekunle  1 , Ruth Lyrea  4 , Onoja Akpa  1 , Rufus Akinyemi  1 , Fred Sarfo  7 , Mayowa Owolabi  1 , Bruce Ovbiagele  8
Affiliations
Multicenter Study

Pre-Stroke Depression in Ghana and Nigeria: Prevalence, Predictors and Association With Poststroke Depression

Akin Ojagbemi et al. J Geriatr Psychiatry Neurol. 2022 Jan.

Abstract

Objectives: Depression is a risk factor for stroke. There is a knowledge gap on the predictors of prestroke depression in stroke survivors living in low- and middle-income countries (LMICs). We estimated prevalence and predictors of prestroke depression, as well as its association with poststroke depression (PSD) in the largest study of stroke in Africa.

Methods: We evaluated information collected as part of the Stroke Investigative Research and Education Network (SIREN) study, a multicentre, case-control study conducted at 15 sites in Ghana and Nigeria. Prestroke depression status was ascertained in stroke survivors using a validated self-report tool, while PSD was assessed using a stroke specific screening tool for depression ("HRQOLISP-E"). Independent associations were investigated using complementary log-log regression and binary logit models.

Results: Among 1,977 participants, prestroke depression was found in 141 (7.1%). In multivariate analyses, prestroke depression was significantly associated with tachycardia (OR = 2.22, 95% CI = 1.37-3.56) and low consumption of green leafy vegetables (OR = 1.91, 95% CI = 1.12-3.24). Forty-one (29.1%) of the prestroke depression sub-sample developed PSD. However, prestroke depression was not significantly associated with PSD.

Conclusion: The findings should energize before-the-stroke identification and prioritization of limited treatment resources in LMICs to persons with depression who have multiple, additional, risks of stroke.

Keywords: Sub-Saharan Africa; mental health complications; prestroke symptoms; stroke burden; stroke risk factors.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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