In a recent study, 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. Photo by Gerd Altmann
While many people suffer from depression after a stroke, a new study suggests depression often occurs beforehand and may be a warning sign.
"The study underscores why doctors need to monitor for symptoms of depression long term in people who have had strokes," said study author Maria Blöchl of the University of Münster, in Germany.
For the study, Blöchl and her colleagues looked at more than 10,000 adults without a history of stroke (average age, 65). Over about 12 years of follow-up, 425 had a stroke. These patients were compared to more than 4,200 people with similar backgrounds who did not have a stroke.
The study participants were surveyed every two years. They were asked whether they had experienced symptoms of depression in the past week, including feelings of loneliness, sadness, restless sleep, or feelings that everything was difficult to accomplish.
The surveys revealed that symptoms of depression often preceded strokes and got worse afterwards.
While both groups had similar scores from six years before, as the years went on, participants who were about to suffer a stroke became increasingly depressed, up until they fell ill, the study authors said.
"Depression is among the most pressing problems in people who have had a stroke and it is so common it is referred to as post-stroke depression," Blöchl said in a news release from the American Academy of Neurology. "But our study found depressive symptoms not only markedly increase after stroke, it found people already had developed some depressive symptoms before the stroke even occurred."
In the pre-stroke assessments, 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 the stroke, 34% met the criteria for probable depression, the investigators found.
"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 mood and fatigue-related symptoms, may be a signal a stroke ... is about to occur," Blöchl said. "Whether these pre-stroke changes can be used to predict who will have a stroke is unclear."
She said further study is needed to learn exactly why depressive symptoms occur before a stroke.
The findings were published online Wednesday in Neurology.
The U.S. National Institutes of Health has more about stroke.
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