Key result
Late-onset depression (≥40 years) was associated with increased bifurcation CIMT compared to controls (0.81 vs. 0.75 mm, P=0.004), and older age of onset increased plaque presence (OR 1.35).
Why the study?
Is depressive or anxiety disorder, or its age of onset, associated with increased subclinical carotid atherosclerosis in adults?
Case-Control (n=649)
Is depressive or anxiety disorder, or its age of onset, associated with increased subclinical carotid atherosclerosis in adults?
Late-onset depression (≥ 40 years) is associated with increased subclinical carotid atherosclerosis, suggesting a distinct vascular pathophysiology compared to early-onset depression.
Suggests vascular contribution to late-onset depression; hypothesis-generating and should not yet change practice.
OBJECTIVE: Mental health and cardiovascular disease have been associated, whereas the temporal course and underlying mechanisms are still incompletely understood. Our aims were to examine the presence of subclinical atherosclerosis in subjects with depressive or anxiety disorder, also taking into account disorder characteristics (subtype, severity, duration, age of onset, medication). METHODS: The sample included 470 depression or anxiety cases and 179 controls, aged 20-66 years, participating in the Netherlands Study of Depression and Anxiety (NESDA). Diagnoses were assigned using the DSM-IV based Composite International Diagnostic Interview. Carotid intima-media thickness (CIMT) and plaque information were obtained using B-mode ultrasound imaging. RESULTS: Overall, depressive and anxiety disorders were not associated with carotid atherosclerosis. However, age of depression onset was associated with CIMT (total: 0.01 mm per 10 years, P = 0.01; bifurcation: 0.02 mm per 10 years, P = 0.003) and plaque presence (OR = 1.35 per 10 years, 95%CI = 1.02-1.80, P = 0.04). When compared with controls, late-onset (≥ 40 years) depressed had an increased CIMT in the atherosclerosis progression-prone bifurcation segment (0.75 vs. 0.81 mm, P = 0.004). CONCLUSIONS: These findings suggest a distinct pathophysiology of late-onset as compared with early-onset depression, including a vascular component.
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Seldenrijk et al. (2011) conducted a case-control in Depression and anxiety (n=649). Depression, anxiety, and age of depression onset vs. Controls was evaluated on Carotid intima-media thickness (CIMT) and plaque presence (OR 1.35, 95% CI 1.02-1.80, p=0.04). Late-onset depression (≥40 years) was associated with increased bifurcation CIMT compared to controls (0.81 vs. 0.75 mm, P=0.004), and older age of onset increased plaque presence (OR 1.35).
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