The Age-Dependent Association Between Vascular Risk Factors and Depressed Mood

Abstract

Objectives Cumulative burden of vascular risk factors (VRFs) has been linked to an increased risk of depressed mood. However, the role of age in this association is still unclear. Here, we investigated whether VRF burden is associated with levels and changes in depressed mood and whether these associations become stronger or weaker from mid- to later life. Method We used longitudinal data from 5,689 participants (52–89 years) of the English Longitudinal Study of Ageing. A composite score incorporated the presence of 5 VRFs: hypertension, diabetes, smoking, obesity, and hypercholesterolemia. Second-order latent growth models were used to test whether levels and changes of depressed mood differed as a function of baseline VRF burden, and whether these associations were moderated by age. Results Baseline VRF burden showed a small association with higher levels of depressed mood (estimate = 0.081; 95% CI: 0.024, 0.138, p = .005). This association varied with age, such that it was stronger in midlife compared to later life (estimate = −0.007; 95% CI: −0.013, −0.002, p = .017). There was no evidence that VRF burden was associated with changes in depressed mood. Discussion Our findings suggest that VRF burden in midlife, but less so in later life, predicts individual differences in depressed mood. These findings are consistent with reports on the importance of midlife VRFs and support the idea that promotion of vascular health in this age group or earlier in life may be critical to maintain mental health across adulthood.

Mediation of the Association Between Vascular Risk Factors and Depressive Symptoms by C-Reactive Protein: Longitudinal Evidence from the UK Biobank

“…Our findings are in line with several studies showing a small association between cumulative burden from multiple VRFs and depressive symptoms in mid-and later life [9,11,12]. Importantly, our results inform the debate on mechanisms underlying the VRF-depression relationship by suggesting that the small depressogenic effect of VRFs is, at least in part, due to their inflammation-promoting characteristics.…”

“…Vascular risk factors (VRFs) have also been implicated in the aetiology of mood disorders, particularly in later life depression [2][3][4]. Although findings have not always been consistent [5][6][7], a number of prospective populationbased studies support that people with VRFs are at higher risk for developing depression and depressive symptoms [8][9][10][11][12]. This association is particularly strong for burden from multiple VRFs [9], which often tend to accumulate [13].…”

Vascular risk factors, white matter microstructure, and depressive symptoms: A longitudinal analysis in the UK Biobank

“…The results of our study are largely consistent with findings showing small associations between higher VRF burden and depressive symptoms [2,5,6]. However, it has to be noted that the association between rFRS and depressive symptoms was not statistically significant in this sample, while significant associations were found for the VRF z-score and sum score.…”

“…In addition to the pre-registered z-score, we calculated two VRF burden indices that are commonly used: a VRF sum score and the revised Framingham Risk Score (rFRS). The VRF sum score indicates the number of VRFs per person and has been established as a predictor of depressive symptoms [5]. It was calculated by summing dichotomised variables indicating the presence of different VRFs: systolic blood pressure with self-reports of hypertension to indicate hypertension (0 = no, 1 = yes), a BMI ≥ 25kg/m² to indicate the presence of obesity (0 = no, 1 = yes), self-reported diagnosis of high cholesterol (0 = no, 1 = yes), self-reported diagnosis of diabetes (0 = no, 1 = yes), and current smoking (0 = no, 1 = yes).…”

“…Vascular risk factors (VRFs), such as hypertension, obesity, hypercholesterolemia, diabetes, and smoking, are common in patients with depression [1,2]. Although the relationship between depression and VRFs seems complex and bidirectional [3,4], previous research has shown that VRFs are associated with higher risk for depression in mid-and later life [2,5,6] and that this association is particularly strong for cumulative burden from multiple VRFs [2,5].…”