Transient ischemic attack and incidence of depression in old age: Evidence from a population-based analysis in Taiwan

Objectives: The association between transient ischemic attack (TIA) and depression has not been investigated previously. This study was aimed to examine the relationship between TIA and depression in old age in Taiwan. Method: This cross-sectional analysis was performed using data from the nationwide 2002 Health Promotion Knowledge, Attitude, Performance Survey in Taiwan. Depressive symptoms were categorized using the Taiwanese Depression Questionnaire with a cutoff point of 18 of 19, and TIA was defined as the sudden or rapid onset of focal neurologic deficit that had fully resolved within 24 hours. Cerebrovascular risk factors (CVRFs) including age, cardiovascular disease, diabetes mellitus, hypertension, antihypertensive drugs, and smoking were used as covariates. Results: Of the total 3,613 subjects aged 65 years and older, 8.2% had previously experienced a TIA. Subjects with depressive symptoms were significantly more likely to have a previous TIA than those without depressive symptoms (17.1%:7.4%, odds ratio [OR] = 2.6, 95% confidence interval [CI] = 1.8-3.8). After controlling of sex, education, functional disability, and CVRFs, TIA was still significantly associated with depression in old age (Adjusted OR = 2.1, 95% CI = 1.4-3.2). Conclusion: Previous TIA was significantly increased risk of depression which cannot be explained by functional disability or CVRFs. This result supported the hypothesis of vascular depression.