Late-Life Depressive Symptoms as Partial Mediators in the Associations between Subclinical Cardiovascular Disease with Onset of Mild Cognitive Impairment and Dementia.
Am J Geriatr Psychiatry
; 26(5): 559-568, 2018 05.
Article
en En
| MEDLINE
| ID: mdl-29254675
ABSTRACT
OBJECTIVE:
To study whether depression contributes to the association between subclinical cardiovascular disease (CVD) and dementia, and identify the contribution's magnitude.METHODS:
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.RESULTS:
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.CONCLUSIONS:
These data suggest late-life depressive symptoms partially mediate the association of subclinical CVD with MCI/dementia onset.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfermedades Cardiovasculares
/
Demencia
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Trastorno Depresivo
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Disfunción Cognitiva
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
/
Female
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Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Geriatr Psychiatry
Asunto de la revista:
GERIATRIA
/
PSIQUIATRIA
Año:
2018
Tipo del documento:
Article