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Depression associated with stroke morbidity and mortality risk
Pan A. JAMA. 2011;306:1241-1249.
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Increased risk for stroke morbidity and mortality is associated with depression, according to a study.
Researchers for the systematic review included studies reporting risk estimates of stroke morbidity or mortality or updated depression status assessed by self-reported scales or clinician diagnosis, according to the study. The studies were found through a search of Medline, Embase and PsycInfo and described the association between depression and stroke morbidity and mortality. Other inclusion criteria included data reported from an original, peer-reviewed study, cohort studies consisting of non-institutionalized adults, and reports of risk estimates of stroke morbidity or mortality in depressed vs. nondepressed individuals.
Overall, researchers found 28 studies reporting 8,478 stroke cases, eight reporting on fatal stroke, three on nonfatal stroke, six on ischemic stroke and two on hemorrhagic stroke. HR for total stroke was 1.45 (95% CI, 1.29-1.63); 1.55 for fatal stroke (95% CI, 1.25-1.93); and 1.25 for ischemic stroke (95% CI, 1.11-1.40). Most of the studies reported a positive association between total stroke and depression. Researchers found that among 100,000 individuals per year, there were 106 total cases for stroke, 53 for ischemic stroke and 22 for fatal stroke.
According to the results, “3.9% of stroke cases in the US could be attributed to depression.” Looking at different subgroups, researchers found an evident increased risk when using clinical diagnosis to define depression; with a high study quality; when there was a follow-up of 10 years or less; featuring participants with a mean age of younger than 65 years; when there was a small study sample; among Asian studies; and with a lack of statistical control for smoking status or BMI.
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