2023-04-22 02:46:09
They identify precipitating factors of this disease that act only in a few hours. Recovery after a stroke is also worse in patients who have reported depressive symptoms.
The relationship between stroke and depression is confirmed in a new study with thousands of patients that has just been published in Neurology. Observational research suggests that depression increases the risk of stroke, both ischemic and hemorrhagic. The work also finds that people with symptoms of depression are more likely to have a worse recovery after acute stroke.
In the 26,877 adults included in the study Interstroke In 32 countries in Europe, Asia, the Americas and the Middle East, more than 13,000 suffered a stroke: 18% of them had symptoms of depression compared with 14% among those who did not have a stroke, according to the authors. of this work, led by Robert Murphy, from the University of Galway, in Ireland.
After adjusting for factors that may play a role, such as age, gender, education, physical activity, and other lifestyle habits, people with symptoms of depression before their stroke had a 46% increased risk of stroke compared with those who did not. They had symptoms of depression.
On the other hand, when analyzing certain subgroups of patients, they did not see that treatment with antidepressants influenced the risk of stroke.
More mortality, but not more severity
Depression did not affect stroke severity; the study found that it did imply a worse recovery measured one month after the event, as well as higher mortality during that period (10% vs. 8.1%).
But the severity of the depression did influence the risk. Patients who reported five or more symptoms of depression had a 54% higher risk of stroke than those without symptoms, those who reported three or four symptoms, and those with one or two had 58% and 35% more, respectively.
“Depression affects people all over the world and can have a wide range of impacts on a person’s life,” says Murphy, for whom “doctors should be aware of these symptoms of depression and can use this information to help guide health initiatives focused on stroke prevention.”
The work confirms the conclusions drawn in previous research, such as the one led by neurologist Marialaura Simonetto, from the University of Miami, in Florida, presented in 2019 at the meeting of the American Academy of Neurology.
This study included 1,104 people with a median age of 70 years, who had never had a stroke. The participants were followed for 14 years.
18% of the participants (198 people) had symptoms of depression at the beginning of the study. After adjusting for other factors that could affect stroke risk, such as diabetes, high blood pressure and smoking, the researchers found that people who had elevated symptoms of depression they were 75% more likely to develop an ischemic stroke than people without symptoms of depression. Every five-point increase in depression test score was associated with a 12% increased risk of ischemic stroke.
Depression and neuropathology
The link between depression and stroke was also the subject, among other neurological pathologies, of the report Depression and Neurology of the Spanish Society of Neurology (SEN). This analysis, presented at the last annual meeting of the scientific society, establishes that if depression is present in 4-5% of the general population, in people with neurological diseases it can reach 30-50%, according to the president of the SEN, José Miguel Lainez.
The prevalence of depression in patients who have survived a stroke is about eight times higher than in the general population. In fact, a quarter of patients are diagnosed with depression in the 2 years after the stroke, according to the data in the report.
The association between worse functional and cognitive recovery after stroke and depression is also reflected in this analysis, coinciding with the study that appears today in Neurology.
Regarding depression as a risk factor –something that could even serve as a marker in the prevention of stroke for doctors, as suggested by study author Robert Murphy-, the specialists recognized in the presentation of the report that it is more difficult to establish.
However, there are factors related to lifestyle habits that accompany depression that may later favor the development of a cerebrovascular accident, and, although it is not determined, it is possible that certain neurotransmitter alterations present in depression affect, over time to the cerebral blood circulation. Sonia Moreno
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