Late-life depression accentuates cognitive weaknesses in older adults with small vessel disease.

Autor: Oberlin LE; Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.; Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY, USA., Respino M; Rush University Medical Center, Chicago, IL, USA., Victoria L; Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.; Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY, USA., Abreu L; Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA., Hoptman MJ; Clinical Research, Nathan Kline Institute, Orangeburg, NY, USA.; Department of Psychiatry, NYU School of Medicine, New York, NY, USA., Alexopoulos GS; Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.; Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY, USA., Gunning FM; Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA. fdg2002@med.cornell.edu.; Weill Cornell Institute of Geriatric Psychiatry, White Plains, NY, USA. fdg2002@med.cornell.edu.
Jazyk: angličtina
Zdroj: Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology [Neuropsychopharmacology] 2022 Jan; Vol. 47 (2), pp. 580-587. Date of Electronic Publication: 2021 Feb 09.
DOI: 10.1038/s41386-021-00973-z
Abstrakt: Neuroimaging features of small vessel disease (SVD) are highly prevalent in older adulthood and associated with significant variability in clinical symptoms, yet the factors predicting these symptom disparities are poorly understood. We employed a novel metric of SVD, peak width of skeletonized mean diffusivity (PSMD), to elucidate the relationship of late-life depression (LLD) to the cognitive presentation of vascular pathology. A total of 109 older adults without a diagnosis of a neurocognitive disorder were enrolled in the study; 44 with major depressive disorder and 65 age-matched controls. Subjects completed neuropsychological testing and magnetic resonance imaging including FLAIR and diffusion tensor imaging sequences, from which white matter hyperintensity volume and diffusion metrics (fractional anisotropy, mean diffusivity, PSMD) were quantified. In hierarchical models, the relationship between vascular burden and cognitive performance varied as a function of diagnostic status, such that the negative association between PSMD and processing speed was significantly stronger in participants with LLD compared to controls. Greater PSMD also predicted poorer performance on delayed memory and executive function tasks specifically among those with LLD, while there were no associations between PSMD and task performance among controls. PSMD outperformed conventional SVD and diffusion markers in predicting cognitive performance and dysexecutive behaviors in participants with LLD. These data suggest that LLD may confer a vulnerability to the cognitive manifestations of white matter abnormalities in older adulthood. PSMD, a novel biomarker of diffuse microstructural changes in SVD, may be a more sensitive marker of subtle cognitive deficits stemming from vascular pathology in LLD.
(© 2021. The Author(s).)
Databáze: MEDLINE
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