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Post-stroke and clinically-defined vascular depression in geriatric rehabilitation patients
Benjamin T Mast1, Susan E MacNeill, Peter A Lichtenberg
1Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA. b.mast@louisville.edu
Insights
Vascular depression is linked to cerebrovascular risk factors (CVRFs) in older adults. Increased CVRF burden predicts depression in non-stroke patients, supporting the vascular depression hypothesis.
Area of Science:
- Geriatric Medicine
- Neurology
- Psychiatry
Background:
- The vascular depression hypothesis suggests a link between cerebrovascular disease and depression.
- Understanding this link is crucial for geriatric populations, where both conditions are prevalent.
Purpose of the Study:
- To test the vascular depression hypothesis by comparing depression rates in stroke patients, those with cerebrovascular risk factors (CVRFs), and those without vascular disease.
- To investigate the relationship between CVRF burden and depression in geriatric rehabilitation patients.
Main Methods:
- A study of 670 geriatric rehabilitation patients was conducted.
- Patients were categorized into three groups: no vascular disease/stroke, CVRFs without stroke, and stroke.
- Logistic regression analysis examined the relationship between CVRFs and depression.
Main Results:
- Depression frequencies were similar across groups: stroke (36.4%), CVRF (35.2%), and non-vascular (28.7%).
- In patients without stroke, increasing CVRF burden significantly predicted depression.
- This association between CVRF burden and depression was not found in stroke patients.
Conclusions:
- Findings support the vascular depression hypothesis.
- Clinically-defined vascular depression and post-stroke depression rates are comparable in geriatric rehabilitation patients.
Objective:
The authors examined the vascular depression hypothesis by comparing the frequency of post-stroke depression and clinically-defined vascular depression and by examining the relationship between vascular burden and depression.
Methods:
Data from 670 geriatric rehabilitation patients were incorporated to compare the frequency of depression in three patient groups: 1) those with no evidence of vascular disease or stroke, 2) those with cerebrovascular risk factors (CVRFs) but no evidence of stroke, and 3) patients with stroke. They examined the unique relationship between CVRFs and depression by use of logistic-regression analysis.
Results:
Although the frequency of depression was not significantly different between stroke (36.4%), CVRF (35.2%), and non-vascular patients (28.7%), there was a significant increase in the frequency of depression in patients without stroke as CVRF burden increased. This effect was not observed among stroke patients. CVRF burden predicted depression among patients without stroke even after controlling for general medical comorbidity, cognitive functioning, and ADL limitations.
Conclusions:
These findings provide empirical support for the vascular depression hypothesis and also indicate that the rates of clinically-defined vascular depression and post-stroke depression are similar in geriatric rehabilitation patients.