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Comparing cardiovascular risk factors in older persons with mild cognitive impairment and lifetime history of major depressive disorder

Published online by Cambridge University Press:  29 March 2021

Wael K. Karameh
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Centre for Addiction and Mental Health, Toronto, Canada Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, St. Michael’s Hospital, Toronto, Canada St. Michael’s Hospital, Toronto, Canada
Ines Kortebi
Affiliation:
University of Toronto, Toronto, Canada
Sanjeev Kumar
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Centre for Addiction and Mental Health, Toronto, Canada
Damien Gallagher
Affiliation:
University of Toronto, Toronto, Canada Sunnybrook Health Sciences Centre, Toronto, Canada
Angela Golas
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Centre for Addiction and Mental Health, Toronto, Canada St. Michael’s Hospital, Toronto, Canada
Krista L. Lanctôt
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Sunnybrook Health Sciences Centre, Toronto, Canada
Meryl A. Butters
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA
Christopher R. Bowie
Affiliation:
Centre for Addiction and Mental Health, Toronto, Canada Queen’s University, Kingston, Canada
Alastair Flint
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Centre for Mental Health, University Health Network, Toronto, Canada
Tarek Rajji
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Centre for Addiction and Mental Health, Toronto, Canada
Nathan Herrmann
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Sunnybrook Health Sciences Centre, Toronto, Canada
Bruce G. Pollock
Affiliation:
Campbell Family Mental Health Research Institute, Division of Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Canada
Benoit Mulsant
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Centre for Addiction and Mental Health, Toronto, Canada
Linda Mah
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, Canada
David G. Munoz
Affiliation:
Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, St. Michael’s Hospital, Toronto, Canada University of Toronto, Toronto, Canada
Tom A. Schweizer
Affiliation:
Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, St. Michael’s Hospital, Toronto, Canada University of Toronto, Toronto, Canada
Corinne E. Fischer*
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Canada Keenan Research Centre for Biomedical Science of St. Michael’s Hospital, St. Michael’s Hospital, Toronto, Canada St. Michael’s Hospital, Toronto, Canada
*
Correspondence should be addressed to: Corinne E. Fischer, St. Michael’s Hospital, 30 Bond St., Room 17-044 Cardinal Carter Wing, Toronto, ON, M5B 1W8, Canada. Phone: +416 864 5320. Email: [email protected]

Abstract

Objectives:

To compare the prevalence of select cardiovascular risk factors (CVRFs) in patients with mild cognitive impairment (MCI) versus lifetime history of major depression disorder (MDD) and a normal comparison group using baseline data from the Prevention of Alzheimer’s Dementia with Cognitive Remediation plus Transcranial Direct Current Stimulation (PACt-MD) study.

Design:

Baseline data from a multi-centered intervention study of older adults with MCI, history of MDD, or combined MCI and history of MDD (PACt-MD) were analyzed.

Setting:

Community-based multi-centered study based in Toronto across 5 academic sites.

Participants:

Older adults with MCI, history of MDD, or combined MCI and history of MDD and healthy controls.

Measurements:

We examined the baseline distribution of smoking, hypertension and diabetes in three groups of participants aged 60+ years in the PACt-MD cohort study: MCI (n = 278), MDD (n = 95), and healthy older controls (n = 81). Generalized linear models were fitted to study the effect of CVRFs on MCI and MDD as well as neuropsychological composite scores.

Results:

A higher odds of hypertension among the MCI cohort compared to healthy controls (p < .05) was noted in unadjusted analysis. Statistical significance level was lost on adjusting for age, sex and education (p > .05). A history of hypertension was associated with lower performance in composite executive function (p < .05) and overall composite neuropsychological test score (p < .05) among a pooled cohort with MCI or MDD.

Conclusions:

This study reinforces the importance of treating modifiable CVRFs, specifically hypertension, as a means of mitigating cognitive decline in patients with at-risk cognitive conditions.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2021

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Footnotes

Co-first authors

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. 5th edn. Arlington, VA: American Psychiatric Association.Google Scholar
Aronow, W. S. (2017). Hypertension and cognitive impairment. Annals of Translational Medicine, 5, 259.10.21037/atm.2017.03.99CrossRefGoogle ScholarPubMed
Barch, D. M. et al. (2012). Cognitive improvement following treatment in late-life depression: relationship to vascular risk and age of onset. The American Journal of Geriatric Psychiatry, 20, 682690.10.1097/JGP.0b013e318246b6cbCrossRefGoogle ScholarPubMed
Busse, A., Bischkopf, J., Riedel-Heller, S. G. and Angermeyer, M. C. (2003). Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria. Results of the Leipzig Longitudinal Study of the Aged (LEILA75+). The British Journal of Psychiatry, 182, 449454.10.1192/bjp.182.5.449CrossRefGoogle Scholar
Byun, M. S. et al. (2016). Association of cerebral amyloidosis, blood pressure, and neuronal injury with late-life onset depression. Frontiers in Aging Neuroscience, 8, 236.10.3389/fnagi.2016.00236CrossRefGoogle ScholarPubMed
Diniz, B. S. et al. (2015). Plasma biosignature and brain pathology related to persistent cognitive impairment in late-life depression. Molecular Psychiatry, 20, 594601.10.1038/mp.2014.76CrossRefGoogle ScholarPubMed
Ettorre, E. et al. (2012). Role of cardiovascular risk factors (CRF) in the patients with mild cognitive impairment (MCI). Archives of Gerontology and Geriatrics, 54, 330332.10.1016/j.archger.2011.04.025CrossRefGoogle Scholar
Heser, K. et al. (2016). Late-life depressive symptoms and lifetime history of major depression: cognitive deficits are largely due to incipient dementia rather than depression. Journal of Alzheimer’s Disease, 54, 185199.10.3233/JAD-160209CrossRefGoogle ScholarPubMed
Hickie, I., Scott, E., Wilhelm, K. and Brodaty, H. (1997). Subcortical hyperintensities on magnetic resonance imaging in patients with severe depression—A longitudinal evaluation. Biological Psychiatry, 42, 367374.10.1016/S0006-3223(96)00363-0CrossRefGoogle ScholarPubMed
Hou, Z., Yuan, Y., Zhang, Z., Bai, F., Hou, G. and You, J. (2012). Longitudinal changes in hippocampal volumes and cognition in remitted geriatric depressive disorder. Behavioural Brain Research, 227, 3035.10.1016/j.bbr.2011.10.025CrossRefGoogle ScholarPubMed
Kivipelto, M. et al. (2001). Midlife vascular risk factors and Alzheimer’s disease in later life: longitudinal, population based study. BMJ, 322, 14471451.10.1136/bmj.322.7300.1447CrossRefGoogle ScholarPubMed
Kloppenborg, R. P., van den Berg, E., Kappelle, L. J. and Biessels, G. J. (2008). Diabetes and other vascular risk factors for dementia: which factor matters most? A systematic review. European Journal of Pharmacology, 585, 97108.10.1016/j.ejphar.2008.02.049CrossRefGoogle ScholarPubMed
Knopman, D. S. et al. (2018). Midlife vascular risk factors and midlife cognitive status in relation to prevalence of mil cognitive impairment and dementia in later life: the Atherosclerosis Risk in Communities Study. Alzheimer’s & Dementia, 14, 14061415.10.1016/j.jalz.2018.03.011CrossRefGoogle Scholar
Lara, E. et al. (2016). Mild cognitive impairment in a Spanish representative sample: prevalence and associated factors. International Journal of Geriatric Psychiatry, 31, 858867.10.1002/gps.4398CrossRefGoogle Scholar
Livingston, G. et al. (2017). Dementia prevention, intervention, and care. Lancet, 390, 26732734.10.1016/S0140-6736(17)31363-6CrossRefGoogle ScholarPubMed
Modrego, P. J. and Ferrández, J. (2004). Depression in patients with mild cognitive impairment increases the risk of developing dementia of Alzheimer type. Archives of Neurology, 61, 12901293.10.1001/archneur.61.8.1290CrossRefGoogle ScholarPubMed
Murata, T. et al. (2001). MRI white matter hyperintensities, (1)H-MR spectroscopy and cognitive function in geriatric depression: a comparison of early- and late-onset cases. International Journal of Geriatric Psychiatry, 16, 11291135.10.1002/gps.501CrossRefGoogle ScholarPubMed
Ownby, R. L., Crocco, E., Acevedo, A., John, V. and Loewenstein, D. (2006). Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Archives of General Psychiatry, 63, 530538.10.1001/archpsyc.63.5.530CrossRefGoogle ScholarPubMed
Petersen, R. C. (2000). Aging, mild cognitive impairment, and Alzheimer’s disease. Neurologic Clinics, 18, 789806.10.1016/S0733-8619(05)70226-7CrossRefGoogle ScholarPubMed
Picano, E., Bruno, R. M., Ferrari, G. F. and Bonuccelli, U. (2014). Cognitive impairment and cardiovascular disease: so near, so far. International Journal of Cardiology, 175, 2129.10.1016/j.ijcard.2014.05.004CrossRefGoogle ScholarPubMed
Valkanova, V. and Ebmeier, K. P. (2013). Vascular Risk factors and depression in later life: a systematic review and meta-analysis. Biological Psychiatry, 73, 406413.10.1016/j.biopsych.2012.10.028CrossRefGoogle ScholarPubMed
Villeneuve, S., Belleville, S., Massoud, F., Bocti, C. and Gauthier, S. (2009). Impact of vascular risk factors and diseases on cognition in persons with mild cognitive impairment. Dementia and Geriatric Cognitive Disorders, 27, 375381.10.1159/000209965CrossRefGoogle ScholarPubMed
Yaffe, K., Hoang, T. D., Byers, A. L., Barnes, D. E. and Friedl, K. E. (2014). Lifestyle and health-related risk factors and risk of cognitive aging among older veterans. Alzheimer’s & Dementia, 10, S111S1121.10.1016/j.jalz.2014.04.010CrossRefGoogle ScholarPubMed
Ye, Q. et al. (2017). Divergent roles of vascular burden and neurodegeneration in the cognitive decline of geriatric depression patients and mild cognitive impairment patients. Frontiers in Aging Neuroscience, 9, 288.10.3389/fnagi.2017.00288CrossRefGoogle ScholarPubMed
Zuidersma, M., Izaks, G. J., Naarding, P., Comijs, H. C. and Oude Voshaar, R. C. (2015). Vascular burden and cognitive function in late-life depression. The American Journal of Geriatric Psychiatry, 23, 514515.10.1016/j.jagp.2014.06.010CrossRefGoogle ScholarPubMed
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