Longitudinal support for the relationship between vascular risk factors and late-life depressive symptoms.
OBJECTIVE
The authors examined longitudinal support for the vascular depression hypothesis by assessing the extent to which baseline vascular burden was associated with depressive symptoms 6 and 18 months after discharge from inpatient medical rehabilitation.


METHODS
One hundred consecutive geriatric rehabilitation patients were assessed during their rehabilitation stay and subsequently screened for depression 6 and 18 months after discharge. Baseline vascular burden was entered into logistic-regression analyses predicting depression at 6 and 18 months after controlling for baseline levels of depression, general medical burden, limitations in activities of daily living, cognitive impairment, and demographic variables including age, education, gender, and race.


RESULTS
Logistic-regression results demonstrated that, after controlling for the covariates described above, baseline vascular burden was associated with increased odds of positive depression screens at 6- and 18-month follow-up assessments. Furthermore, among patients who were not depressed during their rehabilitation stay, vascular burden was predictive of positive depression screens at 6- and 18-month follow-up assessments.


CONCLUSIONS
Greater vascular burden was positively associated with depressive symptoms over time. These findings provide further support for the vascular depression hypothesis in late life and highlight the need for careful clinical monitoring of this frail group of elderly patients.
Mast
Benjamin T
BT
Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA. b.mast@louisville.edu
Neufeld
Stewart
S
MacNeill
Susan E
SE
Lichtenberg
Peter A
PA
D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D017281:Cost of Illness; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006299:Health Services for the Aged; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D012944:Social Support; D011795:Surveys and Questionnaires