Abstract

Epi-Aortic Trunk Evaluation in Elderly Patients with and Without Depression: A Cross-Sectional Study

Author(s): Grazia D Onofrio, Maria Grazia Longo, Michele Pacilli, Daniele Sancarlo, Mariangela Pia Dagostino, Davide Seripa, Michele Lauriola, Leandro Cascavilla, Francesco Paris, Filomena Addante, Antonio Mangiacotti, Sandra Mastroianno, Giuseppe Di Stolfo, Vincenzo Inchingolo, Maurizio Leone, Aldo Russo, Antonio Greco

Background:

In older patients depression and atherosclerosis can occur. The aim of the present study was to determine whether late-life depression (LLD) is associated with presence of carotid atherosclerosis, and to assess the direct proportionality between carotid atherosclerosis and depression severity.

Methods:

456 patients [333 with LLD and 123 without LLD (noLLD)] attending the Ageing Evaluation Unit and Vascular disease Evaluation Unit were recruited. All patients were assessed by a standardized Comprehensive Geriatric Assessment (CGA), Mini Mental State Examination (MMSE), Clock Drawing Test (CDT), Frontal Assessment Battery (FAB), and Hamilton Rating Scale for Depression – 21 items (HDRS-21). All patients had made a B-Mode Ultrasound scan and Color Doppler ultrasound scan of the epi-aortic trunks.

Results:

LLD patients showed significantly a higher grade of cognitive impairment (MMSE:p=0.003), a major impairment in any CGA domains (ADL:p<0.0001; IADL:p<0.0001; MNA:p<0.0001; ESS:p<0.0001; social support network distribution: p=0.017), and more frequent white matter lesions (WMLs:p<0.0001) than noLLD patients. Very severe LLD patients had a higher grade of cognitive impairment (MMSE:p=0.009; FAB:p=0.026; CDT:p=0.006), and a major impairment in any CGA domains (ADL:p=0.006; IADL:p=0.001; MNA:p<0.0001; ESS:p=0.003). WMLs were more frequent in Severe and Very severe LLD patients (p<0.0001). The patients with atherosclerosis were mainly more depressed (p<0.0001), smokers (p=0.002) and with WMLs (p=0.001) than patient without atherosclerosis. Patients with LLD demonstrated significantly a higher frequency in Moderate-severe atherosclerosis (p<0.0001). The severity of LLD seems increasing progressively in patients with Mild and Moderate-severe atherosclerosis, showing that the patients with Very severe LLD were significantly more frequent in Moderate-severe atherosclerosis (p=0.002).

Conclusions:

Subjects with atherosclerosis were more likely to be depressed. Moreover the severity of LLD seems increasing progressively in patients with Mild and Moderate-severe atherosclerosis.