University of Alabama: Depression Increases the Risk of Stroke

The greater the severity of depression and the longer it lasts, the greater the risk of suffering a stroke.

Depressed Person

Depressed Person

Depression is accompanied by many evils. Besides dark thoughts, insomnia, lack of energy or appetite, it can also have a negative effect on our brain. Researchers at the universities of Alabama in Birmingham have investigated the connection between depression and the risk of stroke. The results of their study were published in the journal Neurology Clinical Practice.

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A risk for the depressed

For this study, the researchers collected data from the 24,045 participants (14,516 Caucasians and 9,529 Blacks) who participated in the Regards study conducted by the University of Alabama in Birmingham. This national program, which targets people over 45 years of age with no history of stroke, examines the risk factors associated with ethnic and regional differences in stroke incidence and mortality.

The depressive symptoms of the participants were classified using an assessment grid called CES-D-4. This test, which consists of several questions, evaluates how often the respondents have felt depressed, sad, lonely, and on the verge of tears in recent months.

In nine years, 1,262 participants in the study suffered a stroke. Compared to people without depression symptoms, participants with a medium score of CES-D-4 had a 39% higher risk of stroke, while participants with a high score had a 54% higher risk of triggering a stroke.

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“There are a number of known risk factors for stroke, including hypertension, diabetes and heart disease, but we are beginning to understand that there are also non-traditional risk factors, and depressive symptoms are at the top of this list,” said Virginia Howard, professor at the School of Public Health at the University of Alabama at Birmingham and lead author of the study. These non-traditional risk factors must be considered when talking about stroke prevention.

Better screening for depressed people

No differences were found in risks, depending on ethnic origin. However, according to Cassandra Ford, an assistant professor at the School of Nursing at the University of Alabama, the risks would be more difficult to identify in the black population. Depression often goes undetected and is undiagnosed in black patients, who are often less likely to receive effective care and treatment. These findings suggest that further research is needed to explore non-traditional risk factors for stroke. The implications of our findings underscore the importance of assessing this risk factor in both populations.

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Both researchers believe that the results should help healthcare professionals better recognize the signs of depression in their patients and include stroke as a risk factor. “As nurses, we care about the whole person. Our study supports the inclusion of non-traditional risk factors in patient assessment, such as mental health” Ford concludes.


Depressive symptoms and risk of stroke in a national cohort of blacks and whites from REGARDS



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