Depression, Cognitive Decline Linked in Elderly With CAD
Depression in adults treated for coronary artery disease linked to higher risk of cognitive decline
TUESDAY, March 6 (HealthDay News) -- Older patients with coronary artery disease who have persistent depression have a significantly increased risk of cognitive decline, according to a study published in the March issue of the Archives of General Psychiatry.
Elizabeth A. Freiheit, and colleagues at the University of Calgary in Canada, evaluated 350 patients aged 60 years or older (73.7 percent male) who underwent non-emergent catheterization for coronary artery disease, from Oct. 27, 2003, through Feb. 28, 2007, without prior revascularization, to examine the association between depressive symptoms and cognitive decline during a 30-month period. The mean change in domain and global cognitive scores was assessed from baseline to six, 12, and 30 months and from 12 to 30 months.
The researchers found that, compared to participants with no or baseline-only depression, those with persistent depressive symptoms at baseline and at one or more follow-up visit had significantly greater declines in attention/executive function at 30 months (mean z score change, −0.22), as well as in learning/memory (−0.19), verbal fluency (−0.18), and global cognition (mean Mini-Mental State Examination [MMSE] score change, −0.99), in adjusted analysis. For patients with persistent depressive symptoms who carried the apolipoprotein E (APOE) ε4 allele, there was a significantly greater decline in global cognition (mean MMSE score change, −2.93).
"Depressive symptoms persist in some patients with coronary artery disease, placing them at a greater risk for cognitive decline," the authors write. "Whether this decline is additionally modified by the presence of APOE ε4 requires further investigation."