Associations Between Cerebral Amyloid Angiopathy, Cognitive Impairment, and Depressive Symptoms

BACKGROUND AND OBJECTIVES: Cerebral amyloid angiopathy (CAA) is associated with intracerebral hemorrhage, cognitive decline, and dementia. We examined (1) associations between CAA, cognitive impairment, and depressive symptoms; (2) whether depressive symptoms mediate the relationship between CAA and cognition; and (3) whether CAA neuroimaging markers predict depressive symptom severity. METHODS: Recruitment occurred through memory and stroke prevention clinics across 2 sites. Cross-sectional data from probable CAA and controls were analyzed. Neuropsychological tests were grouped into episodic memory, executive function, and processing speed domains. Scores ≥5 on the Geriatric Depression Scale: Short Form (GDS-15) defined "possible depression." Regression and mediation analyses examined associations among CAA status, cognition, and depressive symptoms, and in CAA, associations between neuroimaging biomarkers and GDS-15. DISCUSSION: CAA participants exhibited greater depressive symptoms and poorer cognition than controls. Depressive symptoms mediated a small portion of the association between CAA and cognition. Cerebral cortex damage may underlie some depressive symptoms. Interventions targeting CAA-related neurodegeneration and treatment of depressive symptoms may support cognitive health in CAA.