Depressive Disorders After 20 Months in Elderly Stroke Patients

Abstract

Background and Purpose-Depression is common after stroke. Reported frequencies vary widely between studies because of differences in patient selection, time from stroke to assessment, evaluation methods and diagnostic criteria. Poststroke depression is related to increased mortality and poorer rehabilitation outcome. Few studies have been done in the elderly, and there is a lack of studies with population-based controls. We aimed to examine the risk of depression in elderly patients one and a half years after stroke and to compare the risk with a population-based control sample. Methods-We examined 149 elderly stroke survivors and 745 age-and sex-matched controls from the general population with semistructured psychiatric examinations and cognitive assessments. Diagnoses were made according to DSM-III-R. Independent samples t test and 2 test were used to test for significance, Mantel-Haenszel odds ratios with 95% CI for relative risk and Tarone statistics for risk differences between groups. Results-The frequency of depression was 34% in stroke patients and 13% in population controls (odds ratio, 3.4; 95% CI, 2.3 to 5.0). The risk of depression was increased in both men and women and in all age groups but not related to the predominant side of stroke symptoms. Conclusion-Depression is common after stroke. It is therefore important to identify depression in stroke patients because it is a treatable condition that may have implications for poorer outcome in relation to rehabilitation and mortality.

The High Prevalence of Anxiety Disorders After Stroke

“…Written informed consent was obtained from all participants (or their guardians) prior to their involvement in the study. Study procedures have been reported M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 6 previously [21,22]. Patients were contacted by letter one year after the stroke.…”

Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008

“…In clinical practice, only a minority of depressed patients are diagnosed and even fewer are treated [551]. Depression has been reported in up to 33% of stroke survivors, compared with 13% of age- and sex-matched controls [552], but reliable estimates of the incidence and prevalence of depression in a stroke cohort are limited [550]. Predictors of post-stroke depression in the rehabilitation setting include increasing physical disability, cognitive impairment and stroke severity [550].…”

Psychiatric Disorders in the Elderly

“…168 Depression is common after stroke. [169][170][171][172][173] A systematic review 169,170 found a pooled estimate of 33% for depression after stroke. In the study by Linden et al, 173 stroke was related to an odds ratio for depression of 3.2 in women and 4.0 in men 1.5 years after the index stroke.…”