Christof Prugger1, Ophelia Godin2, Marie-Cécile Perier2, Karen Ritchie2, Catherine Helmer2, Jean-Philippe Empana2, Christophe Tzourio2, Carole Dufouil2. 1. From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France (C.P., M.-C.P., J.-P.E.); UPMC University Paris 06, UMR-S943, Paris, France (O.G.); INSERM, UMR-S943, Paris, France (O.G.); INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (K.R.); University of Montpellier 1, Montpellier, France (K.R.); INSERM, U897, Epidemiology and Biostatistics, Institute of Public Health and Development (ISPED), Bordeaux, France (C.H.); University of Bordeaux, Bordeaux, France (C.H.); INSERM, Clinical Investigation Center Clinical Epidemiology (CIC-1401), Bordeaux, France (C.H.); and INSERM, U897 (C.T., C.D.) and CIC-1401, Clinical epidemiology branch, Bordeaux Hospital (C.D.), Bordeaux University, Bordeaux, France. christof.prugger@inserm.fr. 2. From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France (C.P., M.-C.P., J.-P.E.); UPMC University Paris 06, UMR-S943, Paris, France (O.G.); INSERM, UMR-S943, Paris, France (O.G.); INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (K.R.); University of Montpellier 1, Montpellier, France (K.R.); INSERM, U897, Epidemiology and Biostatistics, Institute of Public Health and Development (ISPED), Bordeaux, France (C.H.); University of Bordeaux, Bordeaux, France (C.H.); INSERM, Clinical Investigation Center Clinical Epidemiology (CIC-1401), Bordeaux, France (C.H.); and INSERM, U897 (C.T., C.D.) and CIC-1401, Clinical epidemiology branch, Bordeaux Hospital (C.D.), Bordeaux University, Bordeaux, France.
Abstract
OBJECTIVE: To investigate prospectively whether subclinical vascular disease is associated with future depressive symptoms in the elderly. APPROACH AND RESULTS: A multicenter cohort of community-dwelling individuals aged 65 to 85 years was examined for carotid plaque presence and common carotid artery intima-media thickness at baseline and followed up after 2, 4, 7, and 10 years. At baseline and follow-up examinations, depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). High level of depressive symptoms was defined as a CES-D score >16 in men and >22 in women. Among 4125 participants (58% women) at baseline, men more frequently showed carotid plaque presence and had higher mean common carotid artery intima-media thickness than women. After adjustment for major cardiovascular risk factors, carotid plaque presence was associated with a higher CES-D score at the 10-year follow-up in men (+1.46; 95% confidence interval, 0.71-2.20; P<0.001), but not in women. When restricting analyses to individuals without cardiovascular disease at baseline, carotid plaque presence increased the likelihood of high level of depressive symptoms at follow-up examinations in men (odds ratio, 1.47; 95% confidence interval, 1.06-2.05; P=0.022), but not in women. One SD increase in log-transformed common carotid artery intima-media thickness was associated with a higher CES-D score at the 10-year follow-up in women (+0.55; 95% confidence interval, 0.16-0.95; P=0.006) and men (+0.40; 95% confidence interval, 0.02-0.78; P=0.037). Common carotid artery intima-media thickness did not increase the likelihood of high level of depressive symptoms at follow-up in both sexes. CONCLUSIONS: Subclinical vascular disease is associated with the progression of depressive symptoms in elderly men and women and the occurrence of high level of depressive symptoms in elderly men.
OBJECTIVE: To investigate prospectively whether subclinical vascular disease is associated with future depressive symptoms in the elderly. APPROACH AND RESULTS: A multicenter cohort of community-dwelling individuals aged 65 to 85 years was examined for carotid plaque presence and common carotid artery intima-media thickness at baseline and followed up after 2, 4, 7, and 10 years. At baseline and follow-up examinations, depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). High level of depressive symptoms was defined as a CES-D score >16 in men and >22 in women. Among 4125 participants (58% women) at baseline, men more frequently showed carotid plaque presence and had higher mean common carotid artery intima-media thickness than women. After adjustment for major cardiovascular risk factors, carotid plaque presence was associated with a higher CES-D score at the 10-year follow-up in men (+1.46; 95% confidence interval, 0.71-2.20; P<0.001), but not in women. When restricting analyses to individuals without cardiovascular disease at baseline, carotid plaque presence increased the likelihood of high level of depressive symptoms at follow-up examinations in men (odds ratio, 1.47; 95% confidence interval, 1.06-2.05; P=0.022), but not in women. One SD increase in log-transformed common carotid artery intima-media thickness was associated with a higher CES-D score at the 10-year follow-up in women (+0.55; 95% confidence interval, 0.16-0.95; P=0.006) and men (+0.40; 95% confidence interval, 0.02-0.78; P=0.037). Common carotid artery intima-media thickness did not increase the likelihood of high level of depressive symptoms at follow-up in both sexes. CONCLUSIONS: Subclinical vascular disease is associated with the progression of depressive symptoms in elderly men and women and the occurrence of high level of depressive symptoms in elderly men.
Authors: Elizabeth A Ellins; Kirsten E Smith; Lucy T Lennon; Olia Papacosta; S Goya Wannamethee; Peter H Whincup; Julian P Halcox Journal: Open Heart Date: 2017-12-17