Despite these limitations, this study provides additional
evidence that, among white men, white women,
and all blacks aged 25 to 74 years, there is an association
between self-reported depressive symptomatology
and stroke incidence. An extended set of supple-mental analyses supported the robustness of the
prospective association between depression and
stroke. These analyses also demonstrated the consistency
of this association across age groups and provided
evidence that depression itself, along with hopelessness
as a component of depression, was the
operating psychological dimension prospectively associated
with stroke incidence. The suggestion of a
graduated relationship between level of depressive
symptoms and stroke indicates that reducing depression
may be important for everyone, not just those
whose high symptomatology may have clinical implications.
Additional studies are needed to verify these
findings and to elucidate the pathways for the effects
of depression on stroke incidence.