Using the Center for Epidemiologic Studies Depression Scale (CES-D-4), a newly published study has found a link between stroke risk and symptoms of depression. The findings may implicate depression symptoms as a ‘nontraditional’ stroke risk factor, according to the researchers, joining well-known risks like heart disease and high blood pressure.
The study comes from the University of Alabama at Birmingham and was recently published in the journal Neurology: Clinical Practice. The researchers used data on 14,516 white participants and 9,529 black participants, all of whom were at least 45 years old and stroke-free at the start of the study.
The participants were enrolled in the REGARDS national longitudinal study from the University of Alabama at Birmingham, which formed the study to look into which risk factors may be linked with the regional and racial-based disparities seen in cases of strokes and death resulting from strokes.
Using the aforementioned CES-D-4 test, the participants were assessed for depression symptoms, specifically crying spells, sadness, loneliness, and feelings of depression, at the start of the study.
During an average follow-up period of nine years, the study noted 1,262 strokes among the participants. Using the baseline CES-D-4 scores, the researchers found that participants who suffered from stroke during the follow-up period had a 39-percent greater stroke risk than participants who didn’t show any depression symptoms.
That 39-percent increased risk applied to participants who scored one to three on the four-item scale. Participants who scored more than four were linked to a 54-percent greater risk following a demographic adjustment, according to the study.
The study didn’t find different effects in these participants by race, however, underscoring the need for additional research to explore why black populations are at greater stroke risk. The study’s first author Cassandra Ford explained:
The traditional risk factors don’t explain all the difference in stroke risk between races. The results have been mixed among the few studies that enrolled Black participants and examined race and depressive symptoms in relation to stroke. Depression often goes undetected and undiagnosed in Black patients, who are frequently less likely to receive effective care and management.
These findings suggest that further research needs to be conducted to explore nontraditional risk factors for stroke. The implications of our findings underscore the importance of assessing for this risk factor in both populations.
Ultimately, the study indicates that depression symptoms may be a ‘nontraditional’ stroke risk factor alongside the established health risks. This doesn’t, of course, mean that depression symptoms cause stroke or that everyone who is depressed will suffer a stroke. Rather, these symptoms may help doctors assess their patients’ overall risk of stroke alongside many other risk factors like an unhealthy lifestyle and existing health conditions.