Sustained inflammation 1.5 years post-stroke is not associated with depression in elderly stroke survivors

Kate Noonan,^1,2 Sheila G Crewther,^1,2 Leeanne M Carey,^2,4 Michaela C Pascoe,⁵ Thomas Linden<sup>2,3

1</sup>School of Psychological Science, La Trobe University, Bundoora, Victoria, Australia; ²Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, Heidelberg, Victoria, Australia; ³Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; ⁴Department of Occupational Therapy, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia; ⁵Brain Sciences Institute, Swinburne University, Melbourne, Australia

Background: Depression is common in elderly stroke survivors and has been associated with systemic inflammation. We aimed to investigate an elderly population of Swedish stroke patients for evidence of sustained peripheral inflammation 18 months post-stroke and to identify if inflammation is associated with post-stroke depression at 18 months post-stroke.
Methods: The Barthel Index was used to measure the level of impairment in activities of daily living at 3 days post-stroke. Serum concentrations of inflammation markers, ie, C-reactive protein and white cell count, were measured in 149 stroke patients (mean age 81 ± 5.33 years, 35% male) at 18 months post-stroke, and a comparison was made with an age-matched sample of elderly Swedish individuals who had not suffered a stroke. At the same visit, clinical depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised criteria. Severity of depression was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS).
Results: Mean C-reactive protein and white cell count levels in stroke patients were significantly elevated at 18 months post-stroke compared with population probands. Disability scores were associated with MADRS depression scores, but C-reactive protein and white cell count were not.
Conclusion: We found evidence for a sustained peripheral inflammatory response at 18 months post-stroke. C-reactive protein and white cell count were not associated with depression in this study.

Keywords: geriatric, inflammatory, ischemia, mood