Comparison of Risk of Stroke in Patients With and Without Depression: A Systematic Review and Meta-Analysis

Abstract

Individuals with depression face an elevated stroke risk, marked by an unfavorable prognosis. This meta-analysis aims to determine the impact of depression on stroke risk. The current meta-analysis was conducted using the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We selected studies through a systematic review of electronic databases, including PubMed, EMBASE, and CINAHL from January 2011 to January 2023. Google Scholar was utilized to identify supplementary studies. Furthermore, we scrutinized citation lists of reported articles for additional potential studies. Only English-language articles were included in the review. A total of 15 studies were included in this meta-analysis. The pooled sample size was 744,179. Sample size of the included studies ranged from 560 to 487,377. The pooled estimate of 15 studies showed that the risk of stroke was 1.47 times higher in individuals with depression compared to the individuals without depression, and the difference is statistically significant (RR: 1.47, 95% CI: 1.30 to 1.66, p-value<0.001). Age and hypertension emerged as significant predictors of stroke risk in depressed individuals identified through meta-regression. These findings underscore the importance of targeted preventive strategies for depression-related stroke risk, especially considering age-specific considerations and associated factors.

Keywords: depression; major depressive disorder; risk; stroke; systematic review and meta analysis.

Figure 1. PRISMA flowchart of study selection

PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Figure 2. Comparison of risk of stroke

Sources: [12-27]