Association between late-life depression or depressive symptoms and stroke morbidity in elders: a systematic review and meta-analysis of cohort studies

TY - JOUR

T1 - Association between late-life depression or depressive symptoms and stroke morbidity in elders:

T2 - a systematic review and meta-analysis of cohort studies

AU - Cai, Wa

AU - Ma, Wen

AU - Mueller, Christoph

AU - Stewart, Robert

AU - Ji, Jun

AU - Shen, Wei-Dong

N1 - Funding Information: WC is funded by National Natural Science Foundation of China (Grant No. 82004444), Shanghai Municipal Health Commission (Grant No. 20204Y0472), the Youth Medical Talents‐Specialist Program of Shanghai “Rising Stars of Medical Talents” Youth Development Program, Shanghai University of Traditional Chinese Medicine (2022YG‐55). WDS is funded by Shanghai Municipal Health Commission (Grant No. 2021LPTD‐004), Shanghai Municipal Health Commission (Grant No. ZY (2021‐2023)‐0209‐10), Clinical Technology Innovation Project of Municipal Hospital (Grant No. SHDC22021210), Shanghai Science and Technology Commission (Grant No. 20Y21902900). RS is part‐funded by: (i) the NIHR Maudsley Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and King's College London; (ii) the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust; (iii) UKRI – Medical Research Council through the DATAMIND HDR UK Mental Health Data Hub (MRC reference: MR/W014386); (iv) the UK Prevention Research Partnership (Violence, Health and Society; MR‐VO49879/1), an initiative funded by UK Research and Innovation Councils, the Department of Health and Social Care (England) and the UK devolved administrations, and leading health research charities. The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Funding Information: WC is funded by National Natural Science Foundation of China (Grant No. 82004444), Shanghai Municipal Health Commission (Grant No. 20204Y0472), the Youth Medical Talents-Specialist Program of Shanghai “Rising Stars of Medical Talents” Youth Development Program, Shanghai University of Traditional Chinese Medicine (2022YG-55). WDS is funded by Shanghai Municipal Health Commission (Grant No. 2021LPTD-004), Shanghai Municipal Health Commission (Grant No. ZY (2021-2023)-0209-10), Clinical Technology Innovation Project of Municipal Hospital (Grant No. SHDC22021210), Shanghai Science and Technology Commission (Grant No. 20Y21902900). RS is part-funded by: (i) the NIHR Maudsley Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and King's College London; (ii) the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust; (iii) UKRI – Medical Research Council through the DATAMIND HDR UK Mental Health Data Hub (MRC reference: MR/W014386); (iv) the UK Prevention Research Partnership (Violence, Health and Society; MR-VO49879/1), an initiative funded by UK Research and Innovation Councils, the Department of Health and Social Care (England) and the UK devolved administrations, and leading health research charities. The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Publisher Copyright: © 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2023/11

Y1 - 2023/11

N2 - Objective: Whether late-life depression or depressive symptoms are a risk factor of future stroke in elders is important for prevention measures. A systematic review and meta-analysis were used to investigate the association between depression or depressive symptoms and risk of stroke in elders. Methods: Embase, MEDLINE, PsychINFO and Web of Science were searched for studies published from inception to January 6th 2023. Prospective cohort studies reporting quantitative estimates of the association between depression or depressive symptoms and stroke morbidity in participants aged over 60 years were included. Reviews, meta-analyses, case reports, retrospective, cross-sectional, and theoretical studies were excluded. Study screening and data extraction were conducted by two researchers independently. Random-effects meta-analysis was used to estimate pooled adjusted hazard ratios (HRs). Publication bias was evaluated via the symmetry of funnel plots and Egger tests. The Newcastle Ottawa Scale was used to assess the risk of bias. The quality of evidence of synthesis was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The primary outcome was any stroke, including non-fatal, fatal, ischemic and hemorrhagic sub-types. Results: Seventeen studies of 57,761 patients in total were included in the meta-analysis. A positive association was found between depressive disorder or symptoms and stroke risk (HR: 1.39; 95% CI: 1.22-1.58; P < 0.001). Conclusions: Late-life depression or depressive symptoms are a significant risk factor for stroke in older people. Regular assessment and more effective management of associated comorbidities are recommended to reduce stroke risk.

AB - Objective: Whether late-life depression or depressive symptoms are a risk factor of future stroke in elders is important for prevention measures. A systematic review and meta-analysis were used to investigate the association between depression or depressive symptoms and risk of stroke in elders. Methods: Embase, MEDLINE, PsychINFO and Web of Science were searched for studies published from inception to January 6th 2023. Prospective cohort studies reporting quantitative estimates of the association between depression or depressive symptoms and stroke morbidity in participants aged over 60 years were included. Reviews, meta-analyses, case reports, retrospective, cross-sectional, and theoretical studies were excluded. Study screening and data extraction were conducted by two researchers independently. Random-effects meta-analysis was used to estimate pooled adjusted hazard ratios (HRs). Publication bias was evaluated via the symmetry of funnel plots and Egger tests. The Newcastle Ottawa Scale was used to assess the risk of bias. The quality of evidence of synthesis was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The primary outcome was any stroke, including non-fatal, fatal, ischemic and hemorrhagic sub-types. Results: Seventeen studies of 57,761 patients in total were included in the meta-analysis. A positive association was found between depressive disorder or symptoms and stroke risk (HR: 1.39; 95% CI: 1.22-1.58; P < 0.001). Conclusions: Late-life depression or depressive symptoms are a significant risk factor for stroke in older people. Regular assessment and more effective management of associated comorbidities are recommended to reduce stroke risk.

KW - Late-life depression

KW - stroke

KW - elders

KW - systematic review

KW - meta-analysis

UR - https://www.scopus.com/pages/publications/85171480481

U2 - 10.1111/acps.13613

DO - 10.1111/acps.13613

M3 - Article

AN - SCOPUS:85171480481

SN - 0001-690X

VL - 148

SP - 405

EP - 415

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

IS - 5

ER -