Can Worsening Depression Precede Stroke in Older Adults?

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1. You are a member of the healthcare team for a 67-year-old man with new onset of depressive symptoms. According to the analysis of data from ELSA by Blöchl and colleagues, which of the following statements about the trajectory of depressive symptoms several years before and after incident stroke is correct?
   At 2-year prestroke assessment, prevalence of probable depression was significantly greater in individuals with vs without stroke
   Depressive symptom severity on the Center for Epidemiologic Studies Depression Scale (CES-D 8) did not increase significantly before stroke onset
   Depressive symptoms remained increased for 10 years after stroke but were relatively stable over time in stroke-free individuals
   Differences in depressive symptoms between participants with vs without stroke were most pronounced for appetite-related symptoms.
2. According to the analysis of data from the English Longitudinal Study of Ageing (ELSA) by Blöchl and colleagues, which of the following statements about clinical implications of the trajectory of depressive symptoms several years before and after incident stroke is correct?
   Small increases in depressive symptoms in the years before stroke in patients vs control participants are explained solely by their having more vascular risk factors
   Particular attention should be paid to depressive symptoms in the long-term care of older patients and especially to fatigue-related symptoms
   The study proves that declining prestroke cognitive and physical functioning causes depressive symptoms
   The study proves that depression cannot improve following stroke