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Microvascular dysfunction may increase risk for late-life depression

Peripheral and cerebral forms of microvascular dysfunction were associated with increased risk for depression, according to recent findings.

“Evidence suggests a cerebrovascular etiologic cause because late-life depression has been associated with vascular dementia, stroke and white matter hyperintensities. Moreover, a vascular etiologic cause may explain the high recurrence rate of depression, in addition to the high rate of resistance to antidepressants and/or cognitive behavioral therapy; approximately one-third of patients with depression have treatment-resistant depression,” Marnix J. M. van Agtmaal, MD, of Maastricht University Medical Centre, Netherlands, and colleagues wrote.

To assess associations between peripheral and cerebral microvascular dysfunction and late-life depression, researchers conducted a systematic review and meta-analysis of 48 studies, of which eight included longitudinal data, among 43,600 participants aged 40 years and older. Analysis included 9,203 individuals with depression and 72,441 person-years, with mean follow-up of 3.7 years.

Depression was associated with higher levels of plasma endothelial biomarkers, including soluble intercellular adhesion molecule-1 (OR = 1.58; 95% CI, 1.28-1.96), white matter hyperintensities (OR = 1.29; 95% CI, 1.19-1.39), cerebral microbleeds (OR = 1.18; 95% CI, 1.03-1.34) and cerebral microinfarctions (OR = 1.3; 95% CI, 1.21-1.39).

Included studies did not indicate significant associations between albuminuria, retinal vessel diameters and depression.

Longitudinal data indicated that white matter hyperintensities were significantly associated with incident depression (OR = 1.19; 95% CI, 1.09-1.3).

“This meta-analysis shows that generalized microvascular dysfunction is associated with higher odds of depression and that cerebral small vessel disease is associated with an increased risk for the development of depression over time,” the researchers wrote. “These findings support the hypothesis that microvascular dysfunction is causally linked to depression. This finding may have clinical implications, as microvascular dysfunction might provide a potential target for the prevention and treatment of depression.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.