Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-07T02:20:59.071Z Has data issue: false hasContentIssue false
  • English
  • Français

In depressed older persons higher blood pressure is associated with symptoms of apathy. The NESDO study

Published online by Cambridge University Press:  05 March 2015

J. E. F. Moonen ,
A. J. M. de Craen ,
H. C. Comijs ,
P. Naarding ,
W. de Ruijter  and
R. C. van der Mast
J. E. F. Moonen*
Affiliation:
Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
A. J. M. de Craen
Affiliation:
Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
H. C. Comijs
Affiliation:
Department of Psychiatry / EMGO Institute for Health and Care Research / Institute for Neurosciences, VU University Medical Center, Amsterdam, the Netherlands GGZ in Geest, Amsterdam, the Netherlands
P. Naarding
Affiliation:
GGNet, Department of Old-age Psychiatry, University Medical Centre St. Radboud, Nijmegen, the Netherlands
W. de Ruijter
Affiliation:
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
R. C. van der Mast
Affiliation:
Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
*
Correspondence should be addressed to: J. E. F. Moonen, Department of Psychiatry, Leiden University Medical Centre, P.O. Box 10392, 2300 WB, Leiden, the Netherlands. Phone: +31-6470033478; Fax: +31-715248156. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

In older persons, a relationship between both higher and lower blood pressure and depression has inconsistently been reported. Blood pressure may be differentially associated with distinct symptom domains of depression. We examined the cross-sectional relation of current systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) with different depressive symptom domains among depressed older persons.

Methods:

In the Netherlands Study of Depression in Older Persons (NESDO), 270 participants aged 60 years and above were diagnosed with depression in the past month. Using the three corresponding subscales of the Inventory of Depressive Symptoms-Self Report (IDS-SR), motivational, mood and somatic symptom domains were assessed. Additionally, symptoms of apathy were determined with the Apathy Scale. Multiple linear regression was used to examine the cross-sectional relationship between current SBP, DBP and MAP with both IDS-SR subscale and Apathy Scale scores. Unstandardized betas were calculated per 10 mmHg increase in blood pressure measures.

Results:

Mean age of participants was 70.4 years (standard deviation 7.3). Higher SBP (Beta 0.33, t (254) = 2.01, p = 0.045), higher DBP (Beta 0.68, t (254) = 2.15, p = 0.03) and higher MAP (Beta 0.63, t (254) = 2.33, p = 0.02) were associated with higher Apathy Scale scores in the fully adjusted model. Furthermore, a higher SBP was associated with higher IDS-SR mood subscale scores (Beta 0.25, t (254) = 2.13, p = 0.03).

Conclusions:

Depressed older people with higher blood pressure measures had particularly more symptoms of apathy. To disentangle the relationship of blood pressure with late-life depression, it is important to pay attention to the role of apathy symptoms.

Keywords

apathyblood pressuredepressionolder persons
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 9 , September 2015 , pp. 1485 - 1493
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Publishing.Google Scholar
Andersson, S., Krogstad, J. M. and Finset, A. (1999). Apathy and depressed mood in acquired brain damage: relationship to lesion localization and psychophysiological reactivity. Psychological Medicine, 29, 447–456.CrossRefGoogle ScholarPubMed
Babor, T. F., Kranzler, H. R. and Lauerman, R. J. (1989). Early detection of harmful alcohol consumption: comparison of clinical, laboratory, and self-report screening procedures. Addictive Behaviors, 14, 139–157. doi:10.1016/0306-4603(89)90043-9.CrossRefGoogle ScholarPubMed
Beekman, A. T., Deeg, D. J., Braam, A. W., Smit, J. H. and Van, T. W. (1997). Consequences of major and minor depression in later life: a study of disability, well-being and service utilization. Psychological Medicine, 27, 1397–1409.Google Scholar
Bosworth, H. B., Bartash, R. M., Olsen, M. K. and Steffens, D. C. (2003). The association of psychosocial factors and depression with hypertension among older adults. International Journal Geriatric Psychiatry, 18, 1142–1148. doi: 10.1002/gps.1026.Google Scholar
Comijs, H. C. et al. (2011). The Netherlands study of depression in older persons (NESDO); a prospective cohort study. BMC Research Notes, 4, 524. doi: 10.1186/1756-0500-4-524.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. doi:10.1016/0022-3956(75)90026-6.Google Scholar
Gao, S. et al. (2013). Increase in blood pressure precedes clinical depression in elderly primary care patients. International Journal Geriatric Psychiatry, 28, 1099–1100. doi: 10.1002/gps.3957.Google Scholar
Guo, X. et al. (2009). Blood pressure components and changes in relation to white matter lesions: a 32-year prospective population study. Hypertension, 54, 57–62. doi: 10.1161/HYPERTENSIONAHA.109.129700.Google Scholar
Hegeman, J. M., Wardenaar, K. J., Comijs, H. C., De Waal, M. W., Kok, R. M. and van der Mast, R. C. (2012). The subscale structure of the inventory of depressive symptomatology self report (IDS-SR) in older persons. Journal of Psychiatric Research, 46, 1383–1388. doi: 10.1016/j.jpsychires.2012.07.008.Google Scholar
Jorm, A. F. (2001). Association of hypotension with positive and negative affect and depressive symptoms in the elderly. British Journal of Psychiatry, 178, 553–555. doi: 10.1192/bjp.178.6.553.Google Scholar
Kim, B. S., Bae, J. N. and Cho, M. J. (2010). Depressive symptoms in elderly adults with hypotension: different associations with positive and negative affect. Journal of Affective Disorders, 127, 359–364. doi: 10.1016/j.jad.2010.06.024.Google Scholar
Kriegsman, D. M., Penninx, B. W., van Eijk, J. T., Boeke, A. J. and Deeg, D. J. (1996). Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients’ self-reports and on determinants of inaccuracy. Journal of Clinical Epidemiology, 49, 1407–1417. doi:10.1016/S0895-4356(96)00274-0.CrossRefGoogle Scholar
Krishnan, K. R., Hays, J. C., Tupler, L. A., George, L. K. and Blazer, D. G. (1995). Clinical and phenomenological comparisons of late-onset and early-onset depression. American Journal of Psychiatry, 152, 785–788.Google Scholar
Lavretsky, H., Ballmaier, M., Pham, D., Toga, A. and Kumar, A. (2007). Neuroanatomical characteristics of geriatric apathy and depression: a magnetic resonance imaging study. American Journal of Psychiatry, 15, 386–394. doi: 10.1097/JGP.0b013e3180325a16.Google Scholar
Lenoir, H. et al. (2008). Relationship between blood pressure and depression in the elderly. The three-city study. Journal of Hypertension, 26, 1765–1772. doi: 10.1097/HJH.0b013e3283088d1f.Google Scholar
Levy, R. and Dubois, B. (2006). Apathy and the functional anatomy of the prefrontal cortex-basal ganglia circuits. Cerebral Cortex, 16, 916–928. doi: 10.1093/cercor/bhj043.CrossRefGoogle ScholarPubMed
Ligthart, S. A. et al. (2012). Association of vascular factors with apathy in community-dwelling elderly individuals. Archives of General Psychiatry, 69, 636–642. doi: 10.1001/archgenpsychiatry.2011.1858.CrossRefGoogle ScholarPubMed
Ng, T. P., Feng, L., Niti, M. and Yap, K. B. (2010). Low blood pressure and depressive symptoms among Chinese older subjects: a population-based study. American Journal of Medicine, 123, 342–349. doi:10.1016/j.amjmed.2009.09.026.Google Scholar
Pedersen, K. F., Alves, G., Larsen, J. P., Tysnes, O. B., Moller, S. G. and Bronnick, K. (2012). Psychometric properties of the Starkstein apathy scale in patients with early untreated Parkinson disease. American Journal of Geriatric Psychiatry, 20, 142–148. doi: 10.1097/JGP.0b013e31823038f2.CrossRefGoogle ScholarPubMed
Perneger, T. V. (1998). What's wrong with Bonferroni adjustments. BMJ, 316, 1236–1238. doi: http://dx.doi.org/10.1136/bmj.316.7139.1236.Google Scholar
Robert, P. et al. (2009). Proposed diagnostic criteria for apathy in Alzheimer's disease and other neuropsychiatric disorders. European Psychiatry, 24, 98–104. doi: 10.1016/j.eurpsy.2008.09.001.Google Scholar
Rush, A. J., Gullion, C. M., Basco, M. R., Jarrett, R. B. and Trivedi, M. H. (1996). The inventory of depressive symptomatology (IDS): psychometric properties. Psychological Medicine, 26, 477–486.Google Scholar
Siennicki-Lantz, A., Andre-Petersson, L. and Elmstahl, S. (2013). Decreasing blood pressure over time is the strongest predictor of depressive symptoms in octogenarian men. American Journal of Geriatric Psychiatry, 21, 863–871. doi: 10.1016/j.jagp.2012.11.007.Google Scholar
Starkstein, S. E., Mayberg, H. S., Preziosi, T. J., Andrezejewski, P., Leiguarda, R. and Robinson, R. G. (1992). Reliability, validity, and clinical correlates of apathy in Parkinson's disease. The Journal of Neuropsychiatry & Clinical Neurosciences, 4, 134–139.Google Scholar
Thomas, A. J., Perry, R., Kalaria, R. N., Oakley, A., McMeekin, W. and O’Brien, J. T. (2003). Neuropathological evidence for ischemia in the white matter of the dorsolateral prefrontal cortex in late-life depression. International Journal Geriatric Psychiatry, 18, 7–13. doi: 10.1002/gps.720.Google Scholar
van der Mast, R. C. et al. (2008). Vascular disease and apathy in old age. The Leiden 85-Plus study. International Journal Geriatric Psychiatry, 23, 266–271. doi: 10.1002/gps.1872.Google Scholar
Von Korff, M., Ormel, J., Keefe, F. J. and Dworkin, S. F. (1992). Grading the severity of chronic pain. Pain, 50, 133–149. doi:10.1016/0304-3959(92)90154-4.CrossRefGoogle ScholarPubMed
Wittchen, H. U., Robins, L. N., Cottler, L. B., Sartorius, N., Burke, J. D. and Regier, D. (1991). Cross-cultural feasibility, reliability and sources of variance of the composite international diagnostic interview (CIDI). The multicentre WHO/ADAMHA field trials. British Journal of Psychiatry, 159, 645–653, 658.Google Scholar
Yao, H. et al. (2009). Hypertension and white matter lesions are independently associated with apathetic behavior in healthy elderly subjects: the Sefuri brain MRI study. Hypertension Research, 32, 586–590. doi: 10.1038/hr.2009.65.Google Scholar