title: Transient ischemic attack and incident depression.
abstract: OBJECTIVE
  Depression after stroke is common. Like stroke, transient ischemic attack (TIA) is a manifestation of long-term atherosclerotic damage to the brain. However, the risk of depression developing after a TIA is uncertain. We studied whether TIA increases the risk of incident late-life depression.
  
  
  METHODS
  A cohort study of 5095 inhabitants of Rotterdam, the Netherlands, was performed between 1993 and 2005. Participants were aged 56 years or older and free of depression at baseline. TIA and depression were identified through regular standardized examinations and continuous monitoring of medical records. We estimated hazard ratios (HR) with time-varying Cox regression analyses, adjusting for sociodemographic and health-related factors.
  
  
  RESULTS
  During follow-up, 407 depressive syndromes occurred, of which 103 met criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM) for depressive disorders. TIA was significantly associated with the risk of incident depressive syndromes (HR, 1.68; 95% CI, 1.12-2.51) and DSM-defined depressive disorders (HR, 2.42; 95% CI, 1.26-4.67). The risk of depressive syndromes increased with the number of TIA a person had experienced (HR, 1.45; 95% CI, 1.17-1.81), as did the risk of depressive disorders (HR, 1.63; 95% CI, 1.18-2.24). In persons without a history of depression at baseline, we found an almost 3-fold increased risk of DSM-defined depressive disorders (HR, 2.91; 95% CI, 0.96-8.81).
  
  
  CONCLUSIONS
  TIA was independently associated with an increased risk of incident depression. Our finding suggests that symptomatic cerebrovascular disease increases the vulnerability to late-life depression.
authors.affiliation: Erasmus Medical Center, Department of Epidemiology, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Hendrika J
authors.initials: HJ
authors.lastname: Luijendijk
authors.forename: Bruno H Ch
authors.initials: BH
authors.lastname: Stricker
authors.forename: Renske G
authors.initials: RG
authors.lastname: Wieberdink
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Koudstaal
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Monique M
authors.initials: MM
authors.lastname: Breteler
authors.forename: Henning
authors.initials: H
authors.lastname: Tiemeier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000150:complications; D002560:Cerebrovascular Circulation; D015331:Cohort Studies; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012306:Risk