Adults reporting depression more likely to experience strokes

An analysis of U.S. adults older than 50 found that people with high depressive symptoms during consecutive interviews during a two-year period were twice as likely to have a stroke compared with those who had no or few depressive symptoms.

Lead researcher Paola Gilsanz, ScD
, of the Harvard T.H. Chan School of Public Health in Boston, and colleagues published their findings online in the Journal of the American Heart Association on May 13.

They evaluated 16,178 patients who were in the Health and Retirement Study, a longitudinal cohort of adults and their spouses. They included patients who were not institutionalized, had no history of stroke and were at least 50 years old in 1998. The mean age was 65.7, and 58.5 percent of patients were females.

Researchers interviewed patients every two years from 1998 to 2010 and measured depressive symptoms using the eight-item version of the Center for Epidemiologic Studies – Depression scale. They asked patients about their symptoms within the past week and classified them into four categories: (1) stable high for elevated symptoms in two consecutive interviews; (2) recently remitted for elevated symptoms at first assessment followed by no elevated symptoms at the second assessment; (3) recent onset for no elevated symptoms in the first assessment followed by elevated symptoms at the second assessment; and (4) stable low/no for no elevated symptoms at either assessment.

During the study period, 71.7 percent of patients were in the stable low/no depressive symptoms category. Approximately 10 percent of patients were in each of the other three categories.

There were 1,192 strokes during the 12 years. Patients with stable high or remitted depressive symptoms were significantly more likely to have a stroke compared with those who had stable low/no depressive symptoms. There was no difference between the stable high and remitted groups or between the recent onset and stable low/no depressive symptom groups.

“This study, in conjunction with other work confirming that depressive symptoms are causally related to stroke risk, suggests that clinicians should seek to identify and treat depressive symptoms as early as possible relative to their onset, before adverse consequences begin to accumulate,” the researchers wrote.