The weight of subclinical vascular disease & neuroticism in late-life depression

Depression in later life has been associated with negative consequences, for example a higher occurrence of physical diseases and decreased quality of life. It is well known that depression and cardiovascular diseases are associated. Atherosclerosis and neuroticism (tendency for emotional instability) are two important risk factors for developing a late-life depression. Atherosclerosis develops slowly as the result of factors such as overweight and disturbances in metabolism (metabolic syndrome). We examined the association between different symptoms of late-life depression on the one hand, and atherosclerosis and its risk factors on the other hand. We also explored the role of neuroticism in developing a depression in older people.

The study showed an association between late-life depression and vascular diseases at an early stage, in which they have not yet resulted in a heart or cerebral infarct. We found that this association concerned specific depressive symptoms like fatigue, loss of appetite and weight loss. As older people suffer from more severe atherosclerosis, the effect of neuroticism in developing depressive symptoms decreases. More severe atherosclerosis in ageing thus may explain why symptoms of depression might change in older people. Moreover, the association between atherosclerosis might explain why depression is a risk factor for stroke. Interestingly, in this study was found that depressed older patients, without symptoms of neuroticism, were more at risk for a stroke.