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Abstract

Objectives: To determine the trajectory of depressive symptoms several years before and after incident stroke.

Method: We analysed data from 10,797 participants from the English Longitudinal Study of Ageing (ELSA) without a history of stroke at baseline (wave 1). We matched participants with incident stroke during the 12-year follow-up (waves 2-7) to stroke-free individuals using propensity scores accounting for age, gender, education, ethnicity, and vascular risk factors. Trajectories of depressive symptoms before and after stroke were analysed using multilevel models.

Results: Among the 10,797 participants (mean age 64.6 ± 9.9 years, 54.8 % women), we identified 425 individuals with incident stroke. At the assessment before stroke, these individuals demonstrated an increase in depressive symptoms compared to matched controls. There was a further increase in depressive symptoms in stroke survivors after the acute event, which persisted for several years. Symptom-level analyses revealed that differences in depressive symptoms between stroke survivors and stroke-free controls before and after stroke were most pronounced for mood- and fatigue-related symptoms.

Discussion: Incident stroke is associated with long-term increases in depressive symptoms. A small part of this increase occurs in the years before stroke, perhaps indicating the incipient pathological process. Particular attention should be paid to depressive symptoms in the long-term care of patients, and especially to fatigue-related symptoms.