BACKGROUND: According to the vascular depression hypothesis, subclinical cerebrovascular disease can cause depression in older adults. To test this hypothesis, several cross-sectional studies have assessed structural brain parameters, but few have examined hemodynamic alterations in the brain. METHODS: From the Rotterdam Study, we studied a cohort of 1494 participants (65+ years of age) free of depression, dementia, and stroke at baseline. In the middle cerebral artery blood flow velocities and vasomotor reactivity were measured with transcranial Doppler ultrasonography. All participants were repeatedly assessed for depressive symptoms with Centre for Epidemiological Studies-Depression scale (CES-D). Participants with depressive symptoms (CES-D ≥16) had a semi-structured interview, to classify the depression according to DSM-IV criteria. All analyses were adjusted for sociodemographic data, vascular risk factors, and incident stroke. RESULTS: Lower peak-systolic, end-diastolic, and mean blood flow velocities at baseline were associated with higher CES-D scale scores at follow-up. Mean blood flow velocity predicted incident depressive symptoms (odds ratio [OR]: .74, 95% confidence interval [CI]: .60-.91, p = .004) and depressive disorders (OR: .83, 95% CI: .69-.98, p = .032), whereas decreased baseline vasomotor reactivity predicted incident depressive disorders only (OR: .66, 95% CI: .53-.83, p < .001). CONCLUSIONS: Lower blood flow velocity, indicating reduced cerebral metabolism, predicted depressive symptoms and depressive disorders. Reduced vasomotor reactivity, which might indicate cerebral microangiopathy, predicted depressive disorders only, in healthy older adults. These findings provide prospective evidence for vascular depression hypothesis.
BACKGROUND: According to the vascular depression hypothesis, subclinical cerebrovascular disease can cause depression in older adults. To test this hypothesis, several cross-sectional studies have assessed structural brain parameters, but few have examined hemodynamic alterations in the brain. METHODS: From the Rotterdam Study, we studied a cohort of 1494 participants (65+ years of age) free of depression, dementia, and stroke at baseline. In the middle cerebral artery blood flow velocities and vasomotor reactivity were measured with transcranial Doppler ultrasonography. All participants were repeatedly assessed for depressive symptoms with Centre for Epidemiological Studies-Depression scale (CES-D). Participants with depressive symptoms (CES-D ≥16) had a semi-structured interview, to classify the depression according to DSM-IV criteria. All analyses were adjusted for sociodemographic data, vascular risk factors, and incident stroke. RESULTS: Lower peak-systolic, end-diastolic, and mean blood flow velocities at baseline were associated with higher CES-D scale scores at follow-up. Mean blood flow velocity predicted incident depressive symptoms (odds ratio [OR]: .74, 95% confidence interval [CI]: .60-.91, p = .004) and depressive disorders (OR: .83, 95% CI: .69-.98, p = .032), whereas decreased baseline vasomotor reactivity predicted incident depressive disorders only (OR: .66, 95% CI: .53-.83, p < .001). CONCLUSIONS: Lower blood flow velocity, indicating reduced cerebral metabolism, predicted depressive symptoms and depressive disorders. Reduced vasomotor reactivity, which might indicate cerebral microangiopathy, predicted depressive disorders only, in healthy older adults. These findings provide prospective evidence for vascular depression hypothesis.
Authors: Albert Hofman; Guy G O Brusselle; Sarwa Darwish Murad; Cornelia M van Duijn; Oscar H Franco; André Goedegebure; M Arfan Ikram; Caroline C W Klaver; Tamar E C Nijsten; Robin P Peeters; Bruno H Ch Stricker; Henning W Tiemeier; André G Uitterlinden; Meike W Vernooij Journal: Eur J Epidemiol Date: 2015-09-19 Impact factor: 8.082
Authors: Albert Hofman; Sarwa Darwish Murad; Cornelia M van Duijn; Oscar H Franco; André Goedegebure; M Arfan Ikram; Caroline C W Klaver; Tamar E C Nijsten; Robin P Peeters; Bruno H Ch Stricker; Henning W Tiemeier; André G Uitterlinden; Meike W Vernooij Journal: Eur J Epidemiol Date: 2013-11-21 Impact factor: 8.082
Authors: M Arfan Ikram; Guy G O Brusselle; Sarwa Darwish Murad; Cornelia M van Duijn; Oscar H Franco; André Goedegebure; Caroline C W Klaver; Tamar E C Nijsten; Robin P Peeters; Bruno H Stricker; Henning Tiemeier; André G Uitterlinden; Meike W Vernooij; Albert Hofman Journal: Eur J Epidemiol Date: 2017-10-24 Impact factor: 8.082
Authors: Margarita Abi Zeid Daou; Brian D Boyd; Manus J Donahue; Kimberly Albert; Warren D Taylor Journal: J Affect Disord Date: 2017-03-16 Impact factor: 4.839
Authors: Marnix J M van Agtmaal; Alfons J H M Houben; Frans Pouwer; Coen D A Stehouwer; Miranda T Schram Journal: JAMA Psychiatry Date: 2017-07-01 Impact factor: 21.596
Authors: Michael L Alosco; Mary Beth Spitznagel; Naftali Raz; Ronald Cohen; Lawrence H Sweet; Sarah Garcia; Richard Josephson; Manfred van Dulmen; Joel Hughes; Jim Rosneck; John Gunstad Journal: Psychosom Med Date: 2013-07-19 Impact factor: 4.312