Stroke survivors have 50% greater odds of becoming depressed than people who have had a heart attack — especially if they are women, new studies find. The results show that depression is not simply a passing consequence of adjusting to life after stroke, the researchers say.

Investigators followed the health outcomes in 11 million Medicare beneficiaries who were hospitalized for ischemic stroke or heart attack in 2016 and 2017. Patients in whom depression was diagnosed in the six months before the event were not included.

It was a surprise to find that the risk of depression remained persistently elevated post-stroke, said lead author Laura K. Stein, M.D., M.P.H., of the Icahn School of Medicine at Mount Sinai.

In addition to the higher likelihood of depression among the stroke survivors, a history of anxiety was tied to the highest likelihood of depression. In fact, ischemic stroke patients with long-standing anxiety were almost two times more likely to develop depression than patients without anxiety.

In a study using the same dataset, the investigators also found that female stroke patients had a 20% higher odds of developing depression than male stroke patients. Notably, patients aged 75 years and older were slightly less likely to receive a diagnosis of post-stroke depression, and being discharged home also resulted in less depression.

“Depression following stroke is almost three times as common as it is in the general population and may affect up to a third of stroke patients,” Stein said. “Patients with post-stroke depression also experience poorer quality of life and outcomes.”

The results highlight the need for active screening of all stroke patients for post-stroke depression, “including women and those with a history of mental illness,” she concluded.

The study will be presented prior to publication at the American Stroke Association’s International Stroke Conference 2021.

In related news:

Diet high in plant-based food may prevent stroke  People who eat a diet high in healthful plant-based foods such as vegetables, whole grains and beans, and a lower intake of refined grains or added sugars, may reduce their risk of stroke by up to 10%,. That’s according to a study from the Harvard T.H. Chan School of Public Health, Boston, which followed more than 200,000 people followed for more than 25 years. Study participants who ate the most healthful plant-based foods had the lowest odds of stroke compared with those who consumed the least amounts of these foods. A vegetarian diet was not linked to lower stroke risk, however. This may be due to the fact that participants who did not eat meat didn’t necessarily eat healthy foods, the researchers said. The findings will be presented at the American Stroke Association’s International Stroke Conference 2021.