Prevalence and predictors of depression at one year in a Swedish population-based cohort with first-ever stroke

The prevalence of depression after stroke shows considerable variability. Predictors of depression are also not consistent between studies. The aim of this study was to study the prevalence of depression, as well as to study different determinants for depression and life satisfaction one year after a first-ever stroke. One year after the event, we screened survivors (n=253) in a population-based stroke study for depression using the Geriatric Depression Scale. The DSM-IV criteria were used to diagnose depression. Patients were asked how well they were satisfied with life in general. Predictors were evaluated in univariate and multivariate regression models. We found that 37% of the patients crossed cutoff on the Geriatric Depression Scale, and that 27% had a minor or major depression according to the DSM-IV criteria. Independent predictors in multivariate analysis were functional outcome, as measured by the Modified Rankin Scale, ischemic heart disease, and non-lacunar infarction. Independent predictors for a low life satisfaction were depression and functional outcome. We concluded that a low functional outcome predicts depression. Depression has a major impact upon life satisfaction one year after a stroke. Other potential predictors evaluated in this study were of less importance. Active rehabilitation may improve functional outcome, and thence influence depression positively. Also, depression is medically treatable. Follow-up strategies should include measures to detect and manage depression. Traditional scales and definitions of depression may be less reliable in the oldest old.