Depressive Disorders After 20 Months in Elderly Stroke Patients: a Case-control Study

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 chi(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.

Conclusions: 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.