Stroke effects compounded by depression
Because strokes are the third leading cause of death in the United States, the public eye ordinarily focuses on mortality associated with the condition, which is caused by inadequate oxygen supply to the brain. More researchers and clinicians, however, are looking at the quality of life among stroke survivors, a group that includes nearly 2 million in the United States alone. Calling the condition of patients following a stroke “an underappreciated problem in health,” Thomas R. Price of the University of Maryland School of Medicine in Baltimore says a new combination of psychiatry and post-stroke care should help change the attitude that mental impairment can be inevitable in elderly stroke victims.
Work by Price’s group and others shows that strokes are followed by major depression in roughly 50 to 60 percent of patients. This depression goes beyond “feeling blue,” says Price. Studies by the Maryland group indicate that mental capability is significantly impaired among depressed patients, causing signs of dementia for a year or longer. Presence of this depression-linked dementia seems to be dictated by the location of brain damage, says Price. Computed tomography scans used to find brain lesions show that the appearance of depression is most often associated with lesions in the left forward side of the brain. The researchers currently are looking for the biological cause of the depression, using animal studies and imaging methods that detect chemical changes in the brain
Although both depressed and nondepressed stroke patients ordinarily improve with time, Price says depressed patients do not improve as quickly. Many are unaware how common this depression is following strokes, according to Price, who says that “[physicians] don’t diagnose it…and don’t really expect it.” Instead, physicians and families wait for the patient to get better, eventually losing hope. But drug treatments for depression can improve a patient’s prognosis, says Price.