A new study has unveiled previously unknown aspects of depression and its effect on increased stroke risk as well as worse recovery following stroke.

The study, published in the journal Neurology, found people with symptoms of depression were more likely to experience stroke and have worse recovery after having one.

“Depression affects people around the world and can have a wide range of impacts across a person’s life,” said study author Robert P. Murphy of the University of Galway in Ireland, NeuroScienceNews reported.

“Our study provides a broad picture of depression and its link to the risk of stroke by looking at a number of factors including participants’ symptoms, life choices, and antidepressant use. Our results show depressive symptoms were linked to increased stroke risk and the risk was similar across different age groups and around the world,” Murphy explained.

In the study, more than 26,000 adults from the INTERSTROKE study were enrolled. The participants were from 32 countries across Europe, Asia, North and South America, the Middle East and Africa and had an average age of 62.

More than 13,000 people had had a stroke from the cohort. These individuals were matched with more than 13,000 people of similar age, sex, racial or ethnic identity, but who had not experienced a stroke.

At the start of the study, volunteers were made to answer questionnaires on topics such as cardiovascular risk factors, including high blood pressure and diabetes. Researchers also collected data on symptoms of depression a year prior to the study. Specifically, the participants had to report if they had felt sad or depressed for two or more consecutive weeks during the last year.

Following analysis and adjusting for age, sex, education, physical activity, and other lifestyle factors, people with symptoms of depression had a 46% increased risk of stroke in comparison to those with no symptoms of depression, the study found.

Moreover, the results showed a linear relationship between the number of depression symptoms and the risk of stroke. For instance, participants with 5 or more symptoms of depression had a 54% higher risk of stroke than those with no symptoms. Similarly, people who reported 3-4 symptoms of depression and those who reported 1-2 symptoms of depression had 58% and 35% higher risk, respectively.

“In this study, we gained deeper insights into how depressive symptoms can contribute to stroke,” Murphy stated, as per the outlet. “Our results show that symptoms of depression can have an impact on mental health, but also increase the risk of stroke. Physicians should be looking for these symptoms of depression and can use this information to help guide health initiatives focused on stroke prevention.”