Key result
Large subcortical infarcts were associated with an increased risk of depressive symptoms (RR 2.66; 95% CI 1.28-5.54) and poorer executive functioning and memory.
Why the study?
Are structural brain changes associated with depressive symptoms and cognitive impairment in older patients with symptomatic atherosclerotic disease?
Cross-Sectional (n=585)
Are structural brain changes associated with depressive symptoms and cognitive impairment in older patients with symptomatic atherosclerotic disease?
Relative Risk: 2.66 (95% CI 1.28–5.54)
In older patients with symptomatic atherosclerotic disease, subcortical infarcts in projecting white-matter tracts are associated with an increased risk of depressive symptoms and cognitive impairment.
May support mood and cognitive screening in atherosclerotic disease; leaves open causality and need for longitudinal confirmation.
OBJECTIVES: Depression and cognitive impairment are highly prevalent in later life and frequently co-occur. Structural changes in critical brain regions may underlie both conditions. The authors examined associations of infarcts, white-matter lesions (WML) and atrophy at different locations with depressive symptoms and cognitive functioning. METHODS: Within the Second Manifestations of Arterial Disease-Memory, Depression and Aging (SMART-Medea) study, cross-sectional analyses were performed in 585 non-demented patients aged ≥50 years with symptomatic atherosclerotic disease. Volumetric measures of WML and atrophy were obtained with 1.5 T MRI; infarcts were rated visually. Depressive symptoms were assessed with the Patient Health Questionnaire-9 (score ≥6). z Scores of executive functioning, memory and processing speed were calculated. Analyses were adjusted for age, sex, education, intelligence, vascular disease, physical functioning and co-occurring brain changes. RESULTS: Depressive symptoms were present in 102 (17%) patients and were associated with poorer memory (B=-0.26, 95% CI -0.47 to -0.06). Large subcortical infarcts and lacunar infarcts in deep white-matter tracts were both associated with depressive symptoms (RR=2.66, 95% CI 1.28 to 5.54; RR=2.02, 95% CI 1.14 to 3.59) and poorer executive functioning and memory. Periventricular WML volume was associated with poorer executive functioning; cortical infarcts in the left hemisphere and media flow region, ventricular volume and cortical atrophy were associated with a slower processing speed. CONCLUSION: In this sample of non-demented older persons, subcortical infarcts contributed to an increased risk of depressive symptoms as well as cognitive impairment. This depended on location in projecting white-matter tracts, and not on infarct size.
No takes yet. Share an insight, caveat, or question.
Grool et al. (2011) conducted a cross-sectional in symptomatic atherosclerotic disease (n=585). Large subcortical infarcts and lacunar infarcts in deep white-matter tracts was evaluated on depressive symptoms (RR 2.66, 95% CI 1.28-5.54). Large subcortical infarcts were associated with an increased risk of depressive symptoms (RR 2.66; 95% CI 1.28-5.54) and poorer executive functioning and memory.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: