Mental emotional disorder is a predictor of stroke incidence in adults: Ten year results of the Bogor Cohort Study on Non–Communicable Disease Risk Factors in Indonesia

Objective: To determine the stroke predictors for the 10-year of follow-up in Bogor City, Indonesia. Methods: The prospective study analyzed the data of 4445 stroke-free subjects aged 25 years and above that was part of "the Bogor Cohort Study on Non-Communicable Disease Risk Factors". Data were collected by interview method with structured questionnaires, physical measurements three times a year, and laboratory examination every two years during a 10-year follow-up (2011-2021, without examination in 2020). The incidence of stroke is based on anamnesis results and examination by a neurologist. Other stroke predictor variables include characteristics, biological conditions, and risk behavior. We analysed 4445 stroke-free samples with Cox proportional hazard regression test. Results: During the 10-year observation, stroke incidence was 440 person-years per 100000 population (95% CI 370-530). During the follow-up of ten years, the main predictor of stroke was mental-emotional disorders with HR 4.2 (95% CI 2.8-6.3) after adjustment by age, hypertension, obesity, abdominal obesity, and high LDL-cholesterol levels. Conclusions: Mental-emotional disorders are the strongest predictor of stroke incidence. Hence, psychological factors must be controlled in a stroke prevention program.