TY - JOUR
T1 - Chronic Systemic Inflammation Is Associated With Symptoms of Late-Life Depression
T2 - The ARIC Study
AU - Sonsin-Diaz, Natalia
AU - Gottesman, Rebecca F.
AU - Fracica, Elizabeth
AU - Walston, Jeremy
AU - Windham, B. Gwen
AU - Knopman, David S.
AU - Walker, Keenan A.
N1 - Funding Information:
The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts ( HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700005I , HHSN268201700004I ). Neurocognitive data are collected by U012U01HL096812 , 2U01HL096814 , 2U01HL096899 , 2U01HL096902 , 2U01HL096917 from NIH (NHLBI, NINDS, NIA and NIDCD), and with previous brain MRI examinations funded by R01-HL70825 from the NHLBI . The authors thank the staff and participants of the ARIC study for their important contributions. This study was also supported by contracts T32 AG027668 (Dr. Walker) and K24 AG052573 (Dr. Gottesman) from the NIA. The sponsors had no role in the design and conduct of the study; collection management, analysis and interpretation of the data; or preparation review, or approval of the manuscript. The authors thank the staff and participants of the ARIC study for their important contributions.
Funding Information:
The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I,HHSN268201700004I). Neurocognitive data are collected by U012U01HL096812, 2U01HL096814, 2U01HL096899, 2U01HL096902, 2U01HL096917 from NIH (NHLBI, NINDS, NIA and NIDCD), and with previous brain MRI examinations funded by R01-HL70825 from the NHLBI. The authors thank the staff and participants of the ARIC study for their important contributions. This study was also supported by contracts T32 AG027668 (Dr. Walker) and K24 AG052573 (Dr. Gottesman) from the NIA. The sponsors had no role in the design and conduct of the study; collection management, analysis and interpretation of the data; or preparation review, or approval of the manuscript. The authors thank the staff and participants of the ARIC study for their important contributions. RFG serves as Associate Editor for Neurology. DSK serves on a Data Safety Monitoring Board for the DIAN study; and is an investigator in clinical trials sponsored by Biogen, Lilly Pharmaceuticals and the University of Southern California. No other disclosures were reported. No authors were compensated for being co-authors or for helping with the adjudication process.
Publisher Copyright:
© 2019 American Association for Geriatric Psychiatry
PY - 2020/1
Y1 - 2020/1
N2 - Objective: The current study examined how the pattern of systemic inflammation in the decades leading up to late-life relates to depression symptoms in older adults. Methods: Within the Atherosclerosis Risk in Communities Study, we measured high-sensitivity C-reactive protein (CRP), a nonspecific marker of systemic inflammation, at three visits: 21 years and 14 years before, and concurrent with the assessment of depression symptoms, defined using the 11-item Center for Epidemiologic Studies Depression (CESD) scale. We categorized participants into one of four groups based on their 21-year longitudinal pattern of elevated (≥3 mg/L) versus low (<3 mg/L) CRP (stable low; unstable low; unstable elevated; stable elevated). Analyses excluded participants with suspected depression during midlife. Results: A total of 4,614 participants were included (age at CESD assessment: 75.5 [SD: 5.1]; 59% female; follow-up time: 20.7 years [SD: 1.0]). Compared to participants who maintained low CRP levels (stable low), participants who had elevated CRP at two of three visits (unstable elevated; ß = 0.09; 95% confidence interval [CI]: 0.02, 0.17) and participants who maintained elevated CRP at all three visits (stable elevated; ß = 0.13; 95% CI: 0.05, 0.21) had greater depression symptoms as older adults, after adjusting for confounders. After excluding participants with late-life cognitive impairment, only participants with stable elevated CRP demonstrated significantly greater late-life depression symptoms. In a secondary analysis, stable elevated CRP was associated with increased risk for clinically significant late-life depression symptoms. Conclusion: Chronic or repeated inflammation in the decades leading up to older adulthood is associated with late-life depression, even in the context of normal cognition.
AB - Objective: The current study examined how the pattern of systemic inflammation in the decades leading up to late-life relates to depression symptoms in older adults. Methods: Within the Atherosclerosis Risk in Communities Study, we measured high-sensitivity C-reactive protein (CRP), a nonspecific marker of systemic inflammation, at three visits: 21 years and 14 years before, and concurrent with the assessment of depression symptoms, defined using the 11-item Center for Epidemiologic Studies Depression (CESD) scale. We categorized participants into one of four groups based on their 21-year longitudinal pattern of elevated (≥3 mg/L) versus low (<3 mg/L) CRP (stable low; unstable low; unstable elevated; stable elevated). Analyses excluded participants with suspected depression during midlife. Results: A total of 4,614 participants were included (age at CESD assessment: 75.5 [SD: 5.1]; 59% female; follow-up time: 20.7 years [SD: 1.0]). Compared to participants who maintained low CRP levels (stable low), participants who had elevated CRP at two of three visits (unstable elevated; ß = 0.09; 95% confidence interval [CI]: 0.02, 0.17) and participants who maintained elevated CRP at all three visits (stable elevated; ß = 0.13; 95% CI: 0.05, 0.21) had greater depression symptoms as older adults, after adjusting for confounders. After excluding participants with late-life cognitive impairment, only participants with stable elevated CRP demonstrated significantly greater late-life depression symptoms. In a secondary analysis, stable elevated CRP was associated with increased risk for clinically significant late-life depression symptoms. Conclusion: Chronic or repeated inflammation in the decades leading up to older adulthood is associated with late-life depression, even in the context of normal cognition.
KW - Inflammation
KW - cognition
KW - dementia
KW - depression
KW - immunology
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UR - http://www.scopus.com/inward/citedby.url?scp=85066825717&partnerID=8YFLogxK
U2 - 10.1016/j.jagp.2019.05.011
DO - 10.1016/j.jagp.2019.05.011
M3 - Article
C2 - 31182350
AN - SCOPUS:85066825717
SN - 1064-7481
VL - 28
SP - 87
EP - 98
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 1
ER -