Depression May Follow Stroke, Women at Higher Risk

By Ernie Mundell and Robert Preidt
HealthDay reporter

THURSDAY, March 11, 2021 (HealthDay News) – Trauma and loss of stroke can often leave survivors with long-term depression, and women appear to be at particular risk, new research shows.

“We didn’t expect the cumulative risk of depression to remain so consistently high,” study author Dr Laura Stein, assistant professor of neurology at the Icahn School of Medicine, Mount Sinai, told New York.

She said that too often “post-stroke depression is not just a transient consequence of difficulty adjusting to life after stroke.”

In the study, Stein’s team analyzed data from Medicare patients aged 65 and older who were hospitalized for ischemic stroke (over 174,000) or heart attack (over 193,000) from July. 2016 to December 31, 2017. Ischemic stroke is the most common form of stroke and is caused by blocked blood flow to the brain.

The patients were followed for an average of 1.5 years. People with a history of depression in the six months before their stroke or heart attack were excluded.

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While depression can affect any heart patient, Stein’s group found that the risk of depression was about 50% higher in stroke survivors than in heart attack survivors.

Anxiety has often played a role: a history of anxiety was found in 10.3% of patients with stroke and 11.8% of patients with heart attack, and patients with stroke. Strokes with a history of anxiety were almost twice as likely to develop depression as those without anxiety, the study showed. .

Gender and young age also seemed to matter: Patients 75 and older were 19% less likely to be diagnosed with depression than younger patients, and women who had survived a stroke were 20% more likely to develop depression than surviving men.

The results come from two preliminary studies that will be presented later this month at the American Stroke Association’s virtual annual meeting.

“Depression after stroke is almost three times more common than in the general population and can affect up to a third of stroke patients,” Stein said in a press release from the association. She is also a neurologist at the Mount Sinai and Mount Sinai Queens Stroke Centers in New York City.

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A specialist not connected to the new study said the results echoed the experience of many patients.

Brittany LeMonda is a senior neuropsychologist at Lenox Hill Hospital in New York. She said the reason why a stroke is more likely to lead to depression than a heart attack is clear: “People who have stroke can also have greater disability – and loss. of autonomy – whereas patients with a heart attack generally do not cope with the same degree of life changes. “

Identifying the patients most at risk for post-stroke depression can be crucial “for rapid intervention and better results,” she added.

Stein agreed. “Our current results underscore the need for active screening and treatment for depression immediately and well after stroke, as well as the importance of screening all stroke patients for post-stroke depression, including including women and people with a history of mental illness, “she said.

Dr. Andrew Rogove heads stroke services at South Shore University Hospital in Bay Shore, New York. He cautioned against the study, pointing out that “the study population was over the age of 65. It would be interesting to see the post stroke rates. depression in a younger population and to assess whether there are gender differences in the frequency of post-stroke depression in this population. “

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Since the results are to be presented at a medical meeting, they should be considered preliminary until published in a peer-reviewed journal.

More information

The Heart and Stroke Foundation is focusing more on depression after stroke.

SOURCES: Brittany LeMonda, PhD, senior neuropsychologist, Lenox Hill Hospital, New York City; Andrew Rogove, MD, PhD, medical director, Stroke Services, South Shore University Hospital, Bay Shore, NY; American Stroke Association, press release, March 11, 2021

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