Age at Onset and Vascular Pathology in Late-Life Depression
The American Journal of Geriatric Psychiatry,  Clinical Article

Paranthaman R et al. – This study suggests that elderly subjects with late–onset depressed have greater vascular impairment than those with an early–onset illness.

Methods
  • Case–control study.
  • Twenty-five subjects with late-life depression recruited from secondary care were divided into groups with EOD (<60 years, 11 subjects) and LOD (>60 years, 14 subjects).
  • All subjects underwent a variety of vascular assessments including pulse wave analysis, pulse wave velocity, carotid intima media thickness (IMT), and magnetic resonance imaging of the brain to assess white matter hyperintensities.

Results
  • The mean age of LOD subjects was 71.3 ± 4.0 years and EOD was 73.6 ± 4.7 years (p = NS).
  • There were no baseline differences in vascular risk or sociodemographic variables.
  • LOD subjects had significantly higher common carotid IMT (EOD: 0.06 [0.01]; LOD: 0.09 [0.02], p = 0.02), carotid plaques (EOD: 2.1 [1.1]; LOD: 5.4 [3.9], p = 0.02), and peripheral augmentation index (EOD: 81.7 [7.9]; LOD: 96.2 [21.6], p = 0.04) when compared with early-onset subjects, indicating more vascular pathology.
  • There were no group differences in white matter hyperintensities.
  • Age at onset of depression was positively correlated with peripheral augmentation index, common carotid IMT, and plaque index.

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