Improving cardiovascular health could be key in preventing the onset of depression in the elderly

Welcome to our new Research Highlights blog series! A new post series in which we highlight recent noteworthy studies from across PLOS journals. This month, PLOS ONE author Sandra Martín-Peláez of the University of Granada, Spain and colleagues found that cardiovascular risk factors are associated with an increased risk of depression in older adults. Learn more about the study design and authors’ findings below or jump to the full study on our journal site.

Background

Cardiovascular disease and depression are thought to be closely related due to similar risk factors, including inflammation and oxidative stress. Although it has been shown that depression could be a risk factor for developing cardiovascular disease, studies analyzing the potential impact of cardiovascular health on developing depression are scarce.

Study Design

In the new study, the researchers used data from an ongoing 6-year multi-center randomized trial in Spain which analyzes the effect of a Mediterranean Diet on men aged 55-75 and women aged 60-75 with overweight or obesity. 6,545 individuals with no cardiovascular or endocrine disease at baseline were included in the current analysis. A cardiovascular risk score according to the Framingham-based REGICOR function was calculated for each person, dividing participants into low (LR), medium (MR), or high/very high (HR) cardiovascular risk groups. Depressive status was gauged using a questionnaire at baseline and after 2 years of follow-up.

Findings

At baseline, women in the HR group showed higher odds of depressive status than LR women (Odds Ratio* 1.78 95% Confidence Interval** 1.26-2.50). In addition, among all participants with baseline total cholesterol below 160 mg/mL, MR and HR individuals showed higher odds of depression than LR (MR: OR 1.77 95% CI 1.13-2.77; HR: OR 2.83 95% CI 1.25-6.42). On the contrary, among participants with total cholesterol of 280 mg/mL or higher, MR and HR individuals had a lower risk of depression than LR (MR: OR 0.26 95% CI 0.07-0.98; HR: OR 0.23 95% CI 0.05-0.95). After two years, during which time all individuals were instructed to follow a Mediterranean Diet as part of the trial, participants, on average, decreased their depressive status score, with the greatest decreases seen for MR and HR participants with high baseline cholesterol levels.

Conclusion

The authors conclude that high and very high cardiovascular risk are associated with depressive symptoms, especially in women, and that the role of other factors, such as adherence to the Mediterranean Diet, deserves further research.

*Odds Ratio: a statistic that quantifies the strength of the association between two events, A and B

**Confidence Interval: a range of estimates for an unknown parameter

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