Having a high number of depressive symptoms may with an increased risk for stroke, new research suggests. Investigators used data from the Northern Manhattan Study (NOMAS) MRI-Sub-Study, but an ongoing cohort study of primarily Hispanic older adults who clinically free of stroke at baseline and followed for a median of 14 years. Results showed that participants with elevated depressive symptoms at significantly increased risk for incident ischemic stroke compared with those who showed no signs of depression.
Therefore the take-home message is that we found an association between elevated depressive symptoms and incident ischemic stroke,” lead author Marialaura Simonetto, MD. So “This is an observational study that may not suggest causality or changes in clinical practice,” warned Simonetto. The findings will presented at the American Academy of Neurology (AAN) 2019 Annual Meeting in May.

The morbidity and mortality

“Depression has cardiac morbidity and mortality. “However, the impact of mood and depressive symptoms on the risk of incident stroke has been underexplored.”But the current analysis is part of the NOMAS study, a long-standing collaboration between Columbia University, “aims to investigate stroke, stroke risk factors, and stroke epidemiology in minority populations,” Simonetto reported.

The study “demonstrates that depression is a potential risk factor for stroke,” who was not involved with the research. “While the contribution of depression may indirect rather than direct; such as with diabetes or hypertension; it does suggest that depression is a factor that needs to be addressed by healthcare providers.”

Therefore in this study, they aimed to analyze how mood and depressive symptoms may affect stroke risk. The hypothesis was that depressive symptoms would with elevated risk for ischemic stroke. To investigate that question, the researchers assessed 1104 participants (mean age, 70 ± 9 years, 61% women, 69% Hispanic) who free of stroke at MRI baseline. They assessed depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D). An “elevated” symptom score was 16 or higher.

Incident ischemic stroke

Cox proportional hazards models used to estimate hazard ratios (HRs); 95% confidence intervals (CI) for incident ischemic stroke after adjusting for age, sex, race/ethnicity, years of education, smoking status, moderate-to-heavy physical activity, alcohol consumption, diabetes, and hypertension.
The study has several important take-home messages; so including highlighting that depression is “an important medical illness that has a potential for a number of complications; including stroke,” and that the association between depression and stroke is strongest in older women, Adams said. In conclusion, simonetto added that the mechanisms for this association “are complex and not yet fully elucidated; further studies to better understand how mood and depressive symptoms may affect and increase stroke risk are warranted in order to design appropriate primary prevention strategies.”