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The Association between Major Depression, Health Behaviors, and Quality of Life in Adults with Stroke

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.