Long-term Depression Elevates Stroke Risk in Older Adults

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A Harvard University study has found that long-term depression in people over 50 could more than double their risk of having a stroke. The risk remains significantly high even after the depression eases.

Long term depression in 50s increases risk of stroke

The study, published in the Journal of the American Heart Association, is the first to evaluate how changes in depressive symptoms predict changes in stroke risk [1].

The study reviewed health information from over 16,000 men and women ages 50 and older participating in the Health and Retirement Study between 1998 and 2010. Every two years participants were interviewed about a variety of health measures, including depressive symptoms, history of stroke, and risk factors for stroke. During the study period, 7% of participants had a stroke (1,192 occurrences).

Researchers found that people with high depressive symptoms at two consecutive interviews had a 114% higher risk of suffering a first stroke, compared with people without depression at either interview. Those who had depressive symptoms at one interview but not at the next had a 66% higher risk.

The study’s lead author, Paola Gilsanz, from Harvard University’s TH Chan School of Public Health, said [2]:

Our findings suggest that depression may increase stroke risk over the long term. Looking at how changes in depressive symptoms over time may be associated with strokes allowed us to see if the risk of stroke increases after elevated depressive symptoms start or if risk goes away when depressive symptoms do. We were surprised that changes in depressive symptoms seem to take more than two years to protect against or elevate stroke risk.

The scientists did not evaluate whether depressive symptoms diminished due to treatment. However, their findings suggest that even if treatment is effective, there may still be long-term impact on stroke risk. The authors say that their work, together with previous research, points to a need for clinicians to treat depressive symptoms as early as possible.

Although the cause for increased risk of stroke wasn’t studied, one possible mechanism may be an increase in inflammation in the brain. A study published earlier this year found significant elevation of brain inflammation in study participants with depression [3]. Inflammation can lead to reduced health of blood vessels and increased plaque formation, which may increase the risk of stroke.

Depression is a serious mental health condition that requires understanding, treatment and a good recovery plan. Left untreated, depression can be devastating, both for the people who have it and for their families. Symptoms of depression include changes in sleep, changes in appetite, lack of concentration, physical aches and pains, loss of energy and lack of interest, as well as feelings of low self esteem and hopelessness. Depression is an extremely complex disease that can be caused by something as simple as a major life event (including positive events such as starting a new job, graduating or getting married). Genetics is thought to play a role. Additional factors such as conflict, medications, abuse, death or loss, or serious illness may increase the chance of depression. If you’re feeling depressed or concerned about your risk of stroke, you should speak to your doctor.


  1. Gilsanz el al. Changes in Depressive Symptoms and Incidence of First Stroke Among Middle?Aged and Older US Adults. J Am Heart Assoc. 2015 May 13;4(5). pii: e001923. doi: 10.1161/JAHA.115.001923.
    View abstract
  2. Long-term depression may double stroke risk for middle-aged adults. Press release, Harvard T.H. Chan School of Public Health. 2015 May 13.
  3. Setiawan et al. Role of Translocator Protein Density, a Marker of Neuroinflammation, in the Brain During Major Depressive Episodes. JAMA Psychiatry. 2015;72(3):268-275. doi:10.1001/jamapsychiatry.2014.2427.
    View abstract
About the Author

Jenny Jessen is a senior writer at Highlight HEALTH.