Stroke: Eight-year trajectory of depressive symptoms and the association of stroke risk

Evidence suggests a link between depressive symptoms and subsequent stroke risk

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However, most studies assessed depressive symptoms at only one time point, and few studies investigated this relationship using repeated measures of depressive symptoms

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This study aimed to investigate the relationship between depressive symptom trajectories and stroke risk

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This prospective cohort included 12,520 Americans aged ≥50 years who participated in the Health and Retirement Study and were stroke-free at study baseline (1998)

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Depressive symptoms (high defined as ≥3 symptoms; low <3 symptoms) were assessed at 4 consecutive biennial time points from 1998 to 2004

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Based on the individual's score at each time point, they were assigned to 5 predetermined trajectories (persistently low, declining, fluctuating, rising, and persistently high)

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Using self-reported physician diagnoses, incident stroke was assessed over a subsequent 10-year period from 2006 to 2016

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During the follow-up period, 1434 stroke events occurred

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Persistently high depressive symptoms (HR=1.18 [95% CI, 1.02-1.36]), increased symptoms (HR=1.31 [95% CI, 1.10-1.57]), and fluctuating symptoms (HR=1.31 [95% CI, 1.10-1.57]) compared with individuals with persistently low symptoms 1.21 [95% CI, 1.01-1.46]) had a higher risk of stroke

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Individuals in the declining symptom group did not show an increased risk of stroke
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Taken together, depressive symptom trajectories characterized by high symptoms across multiple time points were associated with increased stroke risk
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However, depressive symptoms that started high but declined over time were not associated with higher stroke risk
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Given the remission-relapse nature of depressive symptoms, it is important to understand the relationship between depressive symptoms and stroke risk through repeated assessments
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references:

Eight-Year Depressive Symptom Trajectories and Incident Stroke: A 10-Year Follow-Up of the HRS (Health and Retirement Study).