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Review: depression is associated with an increased risk of stroke in adults

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Does depression affect the risk of developing stroke in adults?


Stroke (any type) and stroke mortality.



Systematic review and meta-analysis.

Data sources

MEDLINE, EMBASE and PsycINFO databases were searched till May 2011. The search was supplemented by manual searches of bibliographies of key retrieved articles and relevant reviews.

Study selection and analysis

Cohort studies of non-institutionalised adults that reported risk estimates of stroke morbidity or mortality for depressed and non-depressed participants. Only English language, peer-reviewed studies were included. Depression status could be assessed by self-reported scales or clinical diagnosis. Data on total stroke were used if available, the order of preference for alternative outcomes was ischaemic stroke, non-fatal stroke or fatal stroke. HRs were used as the preferred measure of association, and RRs were considered equivalent to HRs. Meta-analyses were performed using Stata statistical software version 11.0. The analyses used fixed effects models if there was no or low heterogeneity (Cochran Q statistic p≥0.1 and I2 statistic ≤25%), and random effects models if there was moderate or high heterogeneity. Absolute risk differences and population attributable risk were calculated based on the pooled HRs and background …

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  • Sources of funding National Institutes of Health.


  • Competing interests None.