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'Silent stroke' linked to depression

DALLAS, Oct. 1 -- Researchers have found a connection between depression and 'silent stroke,' a brain abnormality that can lead to a stroke. In a study published today in Stroke: Journal of the American Heart Association, researchers say individuals who develop depression after age 50 should be evaluated for stroke.

A silent stroke occurs when small blood vessels in the brain become blocked or rupture. They are called silent strokes because they are not accompanied by the classic warning signs of stroke such as severe headaches, dizziness or loss of motor skills. Individuals often don't realize they've even had a stroke. Over time, these smaller blood vessels are unable to deliver blood or oxygen to the brain, and cells die. Eventually, an individual may develop problems with memory or concentration and may even have difficulty walking.

"Depression may indicate the presence of small blockages, called lesions, of the blood vessels in the brain that could provide a warning of a potential stroke before it happens," says the study's lead author, David C. Steffens, M.D., assistant professor of psychiatry at Duke University Medical Center in Durham, N.C.

Researchers say the findings suggest that individuals, especially those at risk for stroke, need to be carefully monitored for depression. Depression may indicate that a silent stroke has already occurred. Further work is needed to see if individuals with silent strokes are at risk to develop larger strokes and vascular dementia -- a condition of memory loss and other cognitive problems that result from stroke.

Although earlier studies suggested a link between depression and brain injury, most of those were small. The Duke study examined more than 3,600 elderly individuals enrolled in the Cardiovascular Health Study, which recruited subjects from Medicare lists in four communities -- Forsyth County, N.C.; Sacramento County, Calif.; Washington County, Md.; and Pittsburg
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Contact: Carole Bullock
caroleb@heart.org
214-706-1279
American Heart Association
29-Sep-1999


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