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Depression more likely after stroke than heart attack

Adults who have had strokes – especially women – are more likely to become depressed than those who have had heart attacks, according to two new studies.

One study found people who had strokes were nearly 50% more likely to develop symptoms of depression than people who had heart attacks; another found women were 20% more likely than men to develop depression after a stroke.

"Depression following stroke is almost three times as common as it is in the general population and may affect up to a third of stroke patients," Dr. Laura Stein, a researcher on both studies, said in a news release. She is an assistant professor of neurology at the Icahn School of Medicine at Mount Sinai and an attending neurologist at Mount Sinai and Mount Sinai Queens Stroke Centers in New York City.

Adults with depression after stroke, she said, experience poorer quality of life and outcomes.

Stein and her team analyzed Medicare data for 368,319 adults 65 or older who had been hospitalized for a heart attack or clot-caused stroke from July 2016 to December 2017. They found many people who developed depression had a history of anxiety, which was the strongest predictor of post-stroke depression.

A history of anxiety was found in 10.3% of adults who had strokes and in 11.8% of those who had heart attacks. People who had strokes and a history of anxiety were 1.7 times more likely to develop depression than those who had no history of anxiety. Women, white adults and those younger than 75 also were more likely to be diagnosed with depression following a stroke. Those discharged home from the hospital after a stroke were less likely to become depressed.

A second analysis by the same team calculated the increasing risk for depression among men and women for a year and a half following their strokes and found women were at substantially greater risk than men.

"We did not expect that the cumulative risk of depression would remain so persistently elevated," Stein said. "This finding supports that post-stroke depression is not simply a transient consequence of difficulties adjusting to life after stroke."

The findings, she said, highlight the importance of screening all stroke patients for post-stroke depression. "Our current findings highlight the need for active screening and treatment for depression in the time period immediately and well after the stroke," Stein said.

The research will be presented next week at the American Stroke Association's virtual International Stroke Conference. It is considered preliminary until published in a peer-reviewed journal.


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