DEPRESSION symptoms could precede the onset of stroke and worsen after a stroke has occurred. New recently published research goes further than it did previously, both in understanding that depression is a common challenge in individuals who have suffered a stroke, and discovering that some individuals may suffer from symptoms of depression for years before their stroke.
The study recruited participants to undertake a survey every year inquiring whether they had suffered the symptoms of depression in the last week. Researchers examined 10,797 adults, with an average age of 65, who had no previous history of stroke. The participants were followed for up to 12 years, in which time 425 had a stroke. Individuals who had experienced a stroke were then compared to those of similar age, gender, and racial or ethnic identity, who had not had a stroke within the 12 years.
Analysis of years preceding a stroke event found that 6 years prior to a stroke, people who later had a stroke and those who did not had roughly the same depression assessment score (1.6 points). However, at 2 years prior to stroke, the scores of individuals who later had a stroke started to increase, by an average of 0.33. Subsequent to the stroke event, scores increased an additional 0.23 for the group affected. The scores then remained at 2.1 total points for approximately 10 years after the stroke. By comparison, the scores of individuals who did not experience a stroke remained roughly the same throughout the entire study.
“This suggests that increasing symptoms of depression before stroke are mostly subtle changes and may not always be clinically detectable. But even slight increases in depressive symptoms, especially moods and fatigue-related symptoms, may be a signal that stroke is about to occur,” explained study author, Maria Blöchl, University of Münster, Germany.
During assessment prior to the stroke, researchers found that 29% of people who were about to have a stroke met the criteria for probable depression, compared to 24% of those who did not have a stroke. At the time of stroke, this had increased to 34% of individuals who experienced a stroke, whereas it remained at 24% for those who did not have a stroke.
“Depression is not only a post-stroke issue, but also a pre-stroke phenomenon. Whether these pre-stroke changes can be used to predict who will have a stroke is unclear. Exactly why depressive symptoms occur pre-stroke needs to be investigated in future research. Also, the study underscores why doctors need to monitor for symptoms of depression long term in people who have had strokes,” summarised Blöchl.