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Post-Stroke and Clinically-Defined Vascular Depression in Geriatric Rehabilitation Patients

Received August 15, 2002; revised October 18, October 25, 2002; accepted October 25, 2002. From the Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY (BTM), the Department of Neuropsychology, Henry Ford Health System, Detroit, MI (SEM), and the Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, MI (PAL). Address correspondence to Benjamin T. Mast, Ph.D., Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292. e-mail: b.mast{at}louisville.edu

Objective: The authors examined the vascular depression hypothesis by comparing the frequency of post-stroke depression and clinically-defined vascular depression and by examining the relationship between vascular burden and depression. Methods: Data from 670 geriatric rehabilitation patients were incorporated to compare the frequency of depression in three patient groups: 1) those with no evidence of vascular disease or stroke, 2) those with cerebrovascular risk factors (CVRFs) but no evidence of stroke, and 3) patients with stroke. They examined the unique relationship between CVRFs and depression by use of logistic-regression analysis. Results: Although the frequency of depression was not significantly different between stroke (36.4%), CVRF (35.2%), and non-vascular patients (28.7%), there was a significant increase in the frequency of depression in patients without stroke as CVRF burden increased. This effect was not observed among stroke patients. CVRF burden predicted depression among patients without stroke even after controlling for general medical comorbidity, cognitive functioning, and ADL limitations. Conclusions: These findings provide empirical support for the vascular depression hypothesis and also indicate that the rates of clinically-defined vascular depression and post-stroke depression are similar in geriatric rehabilitation patients.

Key Words: Vascular Depression • Post-Stroke Depression • Rehabilitation

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