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Ellis C, Grubaugh AL, Egede LE. The association between major depression, health behaviors, and quality of life in adults with stroke. International journal of stroke : official journal of the International Stroke Society. 2012 Oct 1; 7(7):536-43.
AIM: The study aims to examine the association between major depression, healthcare behaviors, and quality of life indices among adults with stroke. METHODS: Data from 5869 participants with stroke in the 2006 Behavioral Risk Factor Surveillance Survey were examined. Multiple logistic regression was used to assess the independent association between depression status, self-care and preventive health behaviors, and quality of life indices, after accounting for relevant covariates. RESULTS: In multivariate models, individuals with major depression were less likely to engage in physical activity (odds ratio 0 41; 95% confidence interval 0 29, 0 56) than those without major depression. Women with major depression were also less likely to have received a mammogram in the past two-years (odds ratio 0 61; 95% confidence interval 0 40, 0 96 for women age 40 and odds ratio 0 58; 95% confidence interval 0 36, 0 72 for women age 50) and a pap smear in the past three-years (odds ratio 0 40; 95% CI 0 22, 0 72). In comparisons of quality of life, individuals with major depression were less likely to perceive their health as excellent/very good/good (odds ratio 0 36; 95% confidence interval 0 25, 0 53), to report being satisfied with life (odds ratio 0 13; 95% confidence interval 0 08, 0 20), and to report receiving needed social support (odds ratio 0 42; 95% confidence interval 0 28, 0 63). Individuals who were depressed were also more likely to report one or more poor physical and poor mental health days in the past 30 days (odds ratio 4 56; 95% confidence interval 3 08, 6 76 and odds ratio 10 97; 95% confidence interval 7 75, 15 52, respectively). CONCLUSIONS: In adults with stroke, major depression is associated with decreased engagement in stroke-specific and gender-specific self-care and preventive health behaviors, as well as a broad range of quality of life indices.