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Abstract
Background and Objectives To determine the trajectory of depressive symptoms several years before and after incident stroke.
Methods We analyzed data from 10,797 participants from the English Longitudinal Study of Ageing without a history of stroke at baseline (wave 1). We matched participants with first‐ever stroke during the 12-year follow-up (waves 2–7) to stroke-free individuals using propensity scores accounting for age, sex, education, ethnicity, and vascular risk factors. Trajectories of depressive symptoms before and after stroke were analyzed using multilevel models.
Results Among the 10,797 participants (mean age 64.6 ± 9.9 years, 54.8% women), we identified 425 individuals with incident stroke. At the assessment before stroke, these individuals demonstrated an increase in depressive symptoms when compared with matched controls. There was a further increase in depressive symptoms in stroke survivors after the acute event, which persisted for several years. Symptom-level analyses revealed that differences in depressive symptoms between stroke survivors and stroke-free controls before and after stroke were most pronounced for mood-related and fatigue-related symptoms.
Discussion Incident stroke is associated with long-term increases in depressive symptoms. A small part of this increase occurs in the years before stroke, perhaps indicating the incipient pathologic process. Particular attention should be paid to depressive symptoms in the long-term care of patients, and especially to fatigue-related symptoms.
Glossary
- BMI=
- body mass index;
- CES-D 8=
- Centre for Epidemiologic Studies Depression Scale;
- ELSA=
- English Longitudinal Study of Ageing;
- FDR=
- false discovery rate
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and externally peer reviewed. The handling editor was Brad Worrall, MD, MSc, FAAN.
- Received June 11, 2021.
- Accepted in final form April 5, 2022.
- © 2022 American Academy of Neurology
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