Older people who are depressed or stressed are more likely to have a stroke

By Kathy Oxtoby

BMJ Group News

What do we know already?

Stroke is a major cause of death and disability. We know that diabetes, obesity, high blood pressure, smoking, and a lack of exercise can increase your risk of having a stroke. Studies have also shown that there is a link between depression and stroke. However, we don’t know whether people with psychosocial distress - which is a broad term used to describe a high level of distress, such as depression, stress, a negative outlook or a dissatisfaction with life - are more likely to have a stroke.

To find out more, researchers looked at 2,649 people with an average age of 77 over 10 years to see if there was a link between their psychosocial distress and their risk of having a stroke.

Researchers measured people’s level of distress using tests that gauge stress, which included looking at their dissatisfaction with life, anxiety and symptoms of depression. People in the study gave in-depth interviews about their health problems, how wealthy they were, their behaviour, risk factors for stroke and their social environment.

What does the new study say?

During the 10-year study 151 people died from a stroke, and 452 people had a stroke for the first time.

People with the most psychosocial distress were three times more likely to die from a stroke and were also more likely to have a stroke, compared to people who were the least distressed.

How reliable is the research?

Studies like this can’t tell us whether one thing causes another, so it is not clear if people who are not stressed or depressed or who do not have a negative outlook on life will be protected from having a stroke. These studies can only tell us that there seems to be a link between emotional distress and stroke risk.

While the researchers tried to make sure they took account of other factors that could have affected the results - like whether people had diabetes - it's hard to eliminate all the other possible causes. There are many other factors that could account for the reasons why distressed people were more likely to have a stroke. For example, those who were distressed may not have taken their diabetes medication properly, which could account for their increased chance of a stroke.

What does this mean for me?

This study shows that there may be a link between emotional distress in older people and their risk of having a stroke.

If you have an older relative or are a carer for an older person, this research indicates that you should be aware that if they are feeling distressed this could have an impact on their overall health.

But there are plenty of things people can do to reduce their stroke risk, such as eating a healthy diet, not smoking, taking exercise, and keeping their blood pressure at a healthy level.