Depression linked with first stroke in elderly

NEW YORK (Reuters Health) - The results of a study in the current issue of the journal Stroke suggest that there is an association between depression and an increased risk of having a first stroke in elderly patients.

“It has long been noted that depression is common after stroke and that depression is associated with increased mortality in patients with stroke,” Dr. Ingmar Skoog, of Sahlgrenska University Hospital/Molndal, Sweden, and colleagues write. During the last decade, they add, published reports have suggested that depression may actually contribute to stroke risk.

The current study involved 401 stroke-free 85-year-olds who were participants in the Longitudinal Gerontological and Geriatric Population Studies in Goteborg. At study entry 72 were demented and 329 were dementia-free. The subjects were followed for 3 years and information was obtained from the Swedish Hospital Discharge Register, death certificates, self-reports, and key informants.

The prevalence of depression in the stroke-free subjects at the beginning of the study was 18 percent. Extensive analyses revealed that subjects with depression at study entry had a nearly three-fold increased risk of having a stroke over the 3-year follow-up interval. The investigators also found an association between blood pressure and first-time stroke, in which the stroke risk increased as blood pressure rose.

Depression increased the risk of stroke among both demented and non-demented subjects. Further analysis of 10 symptoms of depression revealed that depressed mood was the only predictor of first-time stroke.

“The findings from this study may have clinical implications because depression and stroke are common in the elderly,” Skoog’s team concludes.

“The possible risk reduction of stroke is thus one more reason why individuals with depression should be diagnosed and adequately treated.”

SOURCE: Stroke, July 2008.