You are here
Late-Life Depressive Symptoms as Partial Mediators in the Associations between Subclinical Cardiovascular Disease with Onset of Mild Cognitive Impairment and Dementia.
Tuesday,2018-01-16 16:50 America/Los_Angeles — ecterry
| Title | Late-Life Depressive Symptoms as Partial Mediators in the Associations between Subclinical Cardiovascular Disease with Onset of Mild Cognitive Impairment and Dementia. |
| Publication Type | Journal Article |
| Year of Publication | 2017 |
| Authors | Armstrong, NM, Carlson, MC, Schrack, J, Xue, Q-L, Carnethon, MR, Rosano, C, Chaves, PHM, Gross, AL |
| Journal | Am J Geriatr Psychiatry |
| Date Published | 2017 Nov 20 |
| ISSN | 1545-7214 |
| Abstract | <p><b>OBJECTIVE: </b>To study whether depression contributes to the association between subclinical cardiovascular disease (CVD) and dementia, and identify the contribution's magnitude.</p><p><b>METHODS: </b>Among participants from the Cardiovascular Health Study Cognition Study who did not have baseline CVD-related events (N = 2,450), causal mediation methodology was implemented to examine whether late-life depressive symptoms, defined as 10-item Center for Epidemiologic Studies-Depression (mCES-D) Scale scores ≥8 from 2 to 3 years after baseline, partially mediated the association of baseline subclinical CVD (CAC, carotid intimal medial thickness, stenosis, and ankle brachial index) with mild cognitive impairment (MCI)/dementia onset occurring between 5 and 10 years from baseline. The total effect was decomposed into direct and indirect effects (via late-life depressive symptoms), obtained from an accelerated failure time model with weights derived from multivariable logistic regression of late-life depressive symptoms on subclinical CVD. Analyses were adjusted by baseline covariates: age, race, sex, poverty status, marital status, body mass index, smoking status, ApoE4 status, and mCES-D.</p><p><b>RESULTS: </b>Participants contributed 20,994 person-years of follow-up with a median follow-up time of 9.4 years. Subclinical CVD was associated with 12% faster time to MCI/dementia (time ratio [TR]: 0.88; 95% CI: 0.83, 0.93). The total effect of subclinical CVD on MCI/dementia onset was decomposed into a direct effect (TR: 0.95, 95% CI: 0.92, 0.98) and indirect effect (TR: 0.92, 95% CI: 0.88, 0.97); 64.5% of the total effect was mediated by late-life depressive symptoms.</p><p><b>CONCLUSIONS: </b>These data suggest late-life depressive symptoms partially mediate the association of subclinical CVD with MCI/dementia onset.</p> |
| DOI | 10.1016/j.jagp.2017.11.004 |
| Alternate Journal | Am J Geriatr Psychiatry |
| PubMed ID | 29254675 |
| Grant List | U01 HL080295 / HL / NHLBI NIH HHS / United States R01 NS085239 / NS / NINDS NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States |
ePub date:
11/17