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Depressive symptoms, vascular disease, and mild cognitive impairment: findings from the Cardiovascular Health Study.
Arch Gen Psychiatry. 2006 Mar; 63(3):273-9.AG

Abstract

CONTEXT

Depressive symptoms are common in patients with dementia and may be associated with increased risk of developing dementia. It has been hypothesized that depressive symptoms and dementia may be attributable to underlying vascular disease in some older persons.

OBJECTIVES

To test the hypotheses (1) that depressive symptoms are associated with increased risk of developing mild cognitive impairment (MCI), a preclinical state that often precedes dementia, and (2) that the association between depressive symptoms and MCI is attributable to underlying vascular disease.

DESIGN

Prospective, population-based, longitudinal study.

SETTING

Random sample of adults 65 years or older recruited from 4 US communities.

PARTICIPANTS

Subjects were 2220 participants in the Cardiovascular Health Study Cognition Study with high cognitive function at baseline. Depressive symptoms were measured at baseline using the 10-item Center for Epidemiological Studies Depression Scale and were classified as none (0-2 points), low (3-7 points), and moderate or high (>/=8 points). Vascular disease measures at baseline included confirmed history of stroke, transient ischemic attack, diabetes mellitus, or hypertension; carotid artery stenosis; ankle-arm blood pressure index; and small or large infarcts or white matter disease on cerebral magnetic resonance imaging. Mild cognitive impairment was diagnosed after 6 years of follow-up based on the consensus of a team of dementia experts using standard clinical criteria.

MAIN OUTCOME MEASURE

Diagnosis of MCI.

RESULTS

Depressive symptoms at baseline were associated with increased risk of MCI (10.0%, 13.3%, and 19.7% for those with no, low, and moderate or high depressive symptoms, respectively). This association was diminished only slightly by adjustment for vascular disease measures and demographics. Vascular disease measures also were associated with increased risk of MCI, and these associations were not diminished by adjustment for depressive symptoms or demographics.

CONCLUSION

Depressive symptoms were associated with increased risk of MCI, and this association was independent of underlying vascular disease.

Authors+Show Affiliations

Department of Psychiatry, University of California, San Francisco 94121, USA. barnes@medicine.ucsf.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16520432

Citation

Barnes, Deborah E., et al. "Depressive Symptoms, Vascular Disease, and Mild Cognitive Impairment: Findings From the Cardiovascular Health Study." Archives of General Psychiatry, vol. 63, no. 3, 2006, pp. 273-9.
Barnes DE, Alexopoulos GS, Lopez OL, et al. Depressive symptoms, vascular disease, and mild cognitive impairment: findings from the Cardiovascular Health Study. Arch Gen Psychiatry. 2006;63(3):273-9.
Barnes, D. E., Alexopoulos, G. S., Lopez, O. L., Williamson, J. D., & Yaffe, K. (2006). Depressive symptoms, vascular disease, and mild cognitive impairment: findings from the Cardiovascular Health Study. Archives of General Psychiatry, 63(3), 273-9.
Barnes DE, et al. Depressive Symptoms, Vascular Disease, and Mild Cognitive Impairment: Findings From the Cardiovascular Health Study. Arch Gen Psychiatry. 2006;63(3):273-9. PubMed PMID: 16520432.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depressive symptoms, vascular disease, and mild cognitive impairment: findings from the Cardiovascular Health Study. AU - Barnes,Deborah E, AU - Alexopoulos,George S, AU - Lopez,Oscar L, AU - Williamson,Jeff D, AU - Yaffe,Kristine, PY - 2006/3/8/pubmed PY - 2006/3/30/medline PY - 2006/3/8/entrez SP - 273 EP - 9 JF - Archives of general psychiatry JO - Arch. Gen. Psychiatry VL - 63 IS - 3 N2 - CONTEXT: Depressive symptoms are common in patients with dementia and may be associated with increased risk of developing dementia. It has been hypothesized that depressive symptoms and dementia may be attributable to underlying vascular disease in some older persons. OBJECTIVES: To test the hypotheses (1) that depressive symptoms are associated with increased risk of developing mild cognitive impairment (MCI), a preclinical state that often precedes dementia, and (2) that the association between depressive symptoms and MCI is attributable to underlying vascular disease. DESIGN: Prospective, population-based, longitudinal study. SETTING: Random sample of adults 65 years or older recruited from 4 US communities. PARTICIPANTS: Subjects were 2220 participants in the Cardiovascular Health Study Cognition Study with high cognitive function at baseline. Depressive symptoms were measured at baseline using the 10-item Center for Epidemiological Studies Depression Scale and were classified as none (0-2 points), low (3-7 points), and moderate or high (>/=8 points). Vascular disease measures at baseline included confirmed history of stroke, transient ischemic attack, diabetes mellitus, or hypertension; carotid artery stenosis; ankle-arm blood pressure index; and small or large infarcts or white matter disease on cerebral magnetic resonance imaging. Mild cognitive impairment was diagnosed after 6 years of follow-up based on the consensus of a team of dementia experts using standard clinical criteria. MAIN OUTCOME MEASURE: Diagnosis of MCI. RESULTS: Depressive symptoms at baseline were associated with increased risk of MCI (10.0%, 13.3%, and 19.7% for those with no, low, and moderate or high depressive symptoms, respectively). This association was diminished only slightly by adjustment for vascular disease measures and demographics. Vascular disease measures also were associated with increased risk of MCI, and these associations were not diminished by adjustment for depressive symptoms or demographics. CONCLUSION: Depressive symptoms were associated with increased risk of MCI, and this association was independent of underlying vascular disease. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/16520432/Depressive_symptoms_vascular_disease_and_mild_cognitive_impairment:_findings_from_the_Cardiovascular_Health_Study_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=16520432.ui DB - PRIME DP - Unbound Medicine ER -