Depression Increases the Risk of Stroke in Older Women

by Dr Sam Girgis on August 16, 2011

Depression is a clinical psychiatric condition that is marked by depressed mood, anhedonia, and reduced energy levels.  Major depressive disorder is a mood disorder that is diagnosed when single or recurrent episodes of depression occur in an individual.  The condition can be very debilitating and can influence the personal, interpersonal, and occupational functional capacity of the individual.  Depression is a significant cause of morbidity throughout the world and has a prevalence that ranges from 8-12% of the population.  Major depression frequently occurs in the presence or in combination with other psychiatric illnesses.  It has been found that depression is associated with an increased risk of sudden cardiac death and fatal coronary artery disease.  Researchers lead by Dr. Kathryn Rexrode from Harvard Medical School have provided evidence that suggests that depression is associated with an increased risk of stroke in older women.  The results of their study were published online in the journal Stroke: Journal of the American Heart Association.  The researchers followed 80,574 women aged 54 to 79 who were enrolled in the Nurse’s Health Study from the years 2000 to 2006.  None of the women had a history of stoke at the onset of the study.  Depression was assessed using the Mental Health Index score at multiple time points throughout the study.  The use of antidepressants was also screened on a biennial basis.  There were 1,033 stokes during the 6 year follow up period.  The researchers found that having a history of depression was associated with increased risk of stroke.  In addition, women who used antidepressant medications also had an increased risk of stroke.  Women who had a prior history of depression but did not currently have depressive symptoms were at a non-significantly increased risk of stroke compared with women who were never diagnosed with depression.  The researchers wrote, “These data provide additional evidence that depression is associated with a moderately increased risk of incident stroke.  The association between current depression status, antidepressant medication use, and risk of stroke deserves further scrutiny. Further research is necessary to determine whether the risk associated with depression can be reduced by other therapies or preventive strategies”.  Future studies will focus on whether the successful treatment of depression decreases the risk of stroke in older women and whether depression should be used when assessing for stroke and other vascular disorders.


An Pan et al. “Depression and Incident Stroke in WomenStroke: Journal of the American Heart Association published online August 11, 2011 doi:10.1161/strokeaha.111.617043

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