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Review: depression is associated with an increased risk of developing stroke

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Question

Question

Is depression associated with an increased risk of developing stroke?

Outcomes

Incidence of stroke (fatal, non-fatal or both).

Methods

Design

Systematic review with meta-analysis.

Data sources

PubMed was searched up to May 2011 without restrictions. Reference lists of obtained articles were also reviewed.

Study selection and analysis

The inclusion criteria were (1) prospective community-based or population-based study; (2) depression or depressive symptoms were the exposure; (3) stroke incidence was the outcome; (4) participants free of stroke at enrolment; and (5) the risk estimate and the corresponding 95% CI of the depression-stroke association were reported. Two reviewers independently carried out the literature search, study selection and data extraction using a standardised data collection form. Disagreements were resolved through discussion. The selected measure of association between depression and stroke was RR. The most fully adjusted risk estimate from each study was pooled in the meta-analysis. Homogeneity of RR from primary studies was tested by Q statistic at p<0.1 and inconsistency across studies was quantified using I2 statistic. Due to the heterogeneity among the studies, a random-effects model was …

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