The evidence that depression precipitates a stroke has been mixed, with studies arriving at conflicting answers. But now the jury may be in, at least as far as middle-aged people are concerned.

For eight years, a research team at the Boston University School of Medicine followed 4,120 people aged 29-100. At the beginning, none had a history of stroke, but after eight years, 228 had suffered either a transient ischemic attack (TIA) (84), an ischemic stroke (122), or a hemorrhagic stroke (22). Those younger than 65 years of age who had been diagnosed with clinical depression were more than four times as likely to have had a TIA or stroke during the study period than those of the same age without depression. Among those 65 and older, however, the risk of a cerebrovascular event was the same whether they were depressed or not (Stroke. 2007;38:16-21).

Depressed patients at heightened risk of stroke were more likely to be women, smokers, teetotalers, unmarried, and users of antidepressant medications. The researchers say they don’t know why depression is linked to stroke, but they added that “increased awareness of the risk in those exhibiting depressive symptoms may identify those who could benefit from primary stroke prevention.”

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