title: Longitudinal association of carotid plaque presence and intima-media thickness with depressive symptoms in the elderly: the three-city study.
abstract: OBJECTIVE
  To investigate prospectively whether subclinical vascular disease is associated with future depressive symptoms in the elderly.
  
  
  RESULTS
  A multicenter cohort of community-dwelling individuals aged 65 to 85 years was examined for carotid plaque presence and common carotid artery intima-media thickness at baseline and followed up after 2, 4, 7, and 10 years. At baseline and follow-up examinations, depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). High level of depressive symptoms was defined as a CES-D score >16 in men and >22 in women. Among 4125 participants (58% women) at baseline, men more frequently showed carotid plaque presence and had higher mean common carotid artery intima-media thickness than women. After adjustment for major cardiovascular risk factors, carotid plaque presence was associated with a higher CES-D score at the 10-year follow-up in men (+1.46; 95% confidence interval, 0.71-2.20; P<0.001), but not in women. When restricting analyses to individuals without cardiovascular disease at baseline, carotid plaque presence increased the likelihood of high level of depressive symptoms at follow-up examinations in men (odds ratio, 1.47; 95% confidence interval, 1.06-2.05; P=0.022), but not in women. One SD increase in log-transformed common carotid artery intima-media thickness was associated with a higher CES-D score at the 10-year follow-up in women (+0.55; 95% confidence interval, 0.16-0.95; P=0.006) and men (+0.40; 95% confidence interval, 0.02-0.78; P=0.037). Common carotid artery intima-media thickness did not increase the likelihood of high level of depressive symptoms at follow-up in both sexes.
  
  
  CONCLUSIONS
  Subclinical vascular disease is associated with the progression of depressive symptoms in elderly men and women and the occurrence of high level of depressive symptoms in elderly men.
authors.affiliation: From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France (C.P., M.-C.P., J.-P.E.); UPMC University Paris 06, UMR-S943, Paris, France (O.G.); INSERM, UMR-S943, Paris, France (O.G.); INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (K.R.); University of Montpellier 1, Montpellier, France (K.R.); INSERM, U897, Epidemiology and Biostatistics, Institute of Public Health and Development (ISPED), Bordeaux, France (C.H.); University of Bordeaux, Bordeaux, France (C.H.); INSERM, Clinical Investigation Center Clinical Epidemiology (CIC-1401), Bordeaux, France (C.H.); and INSERM, U897 (C.T., C.D.) and CIC-1401, Clinical epidemiology branch, Bordeaux Hospital (C.D.), Bordeaux University, Bordeaux, France. christof.prugger@inserm.fr.
authors.forename: Christof
authors.initials: C
authors.lastname: Prugger
authors.affiliation: From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France (C.P., M.-C.P., J.-P.E.); UPMC University Paris 06, UMR-S943, Paris, France (O.G.); INSERM, UMR-S943, Paris, France (O.G.); INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (K.R.); University of Montpellier 1, Montpellier, France (K.R.); INSERM, U897, Epidemiology and Biostatistics, Institute of Public Health and Development (ISPED), Bordeaux, France (C.H.); University of Bordeaux, Bordeaux, France (C.H.); INSERM, Clinical Investigation Center Clinical Epidemiology (CIC-1401), Bordeaux, France (C.H.); and INSERM, U897 (C.T., C.D.) and CIC-1401, Clinical epidemiology branch, Bordeaux Hospital (C.D.), Bordeaux University, Bordeaux, France.
authors.forename: Ophelia
authors.initials: O
authors.lastname: Godin
authors.affiliation: From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France (C.P., M.-C.P., J.-P.E.); UPMC University Paris 06, UMR-S943, Paris, France (O.G.); INSERM, UMR-S943, Paris, France (O.G.); INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (K.R.); University of Montpellier 1, Montpellier, France (K.R.); INSERM, U897, Epidemiology and Biostatistics, Institute of Public Health and Development (ISPED), Bordeaux, France (C.H.); University of Bordeaux, Bordeaux, France (C.H.); INSERM, Clinical Investigation Center Clinical Epidemiology (CIC-1401), Bordeaux, France (C.H.); and INSERM, U897 (C.T., C.D.) and CIC-1401, Clinical epidemiology branch, Bordeaux Hospital (C.D.), Bordeaux University, Bordeaux, France.
authors.forename: Marie-Cécile
authors.initials: MC
authors.lastname: Perier
authors.affiliation: From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France (C.P., M.-C.P., J.-P.E.); UPMC University Paris 06, UMR-S943, Paris, France (O.G.); INSERM, UMR-S943, Paris, France (O.G.); INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (K.R.); University of Montpellier 1, Montpellier, France (K.R.); INSERM, U897, Epidemiology and Biostatistics, Institute of Public Health and Development (ISPED), Bordeaux, France (C.H.); University of Bordeaux, Bordeaux, France (C.H.); INSERM, Clinical Investigation Center Clinical Epidemiology (CIC-1401), Bordeaux, France (C.H.); and INSERM, U897 (C.T., C.D.) and CIC-1401, Clinical epidemiology branch, Bordeaux Hospital (C.D.), Bordeaux University, Bordeaux, France.
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.affiliation: From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France (C.P., M.-C.P., J.-P.E.); UPMC University Paris 06, UMR-S943, Paris, France (O.G.); INSERM, UMR-S943, Paris, France (O.G.); INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (K.R.); University of Montpellier 1, Montpellier, France (K.R.); INSERM, U897, Epidemiology and Biostatistics, Institute of Public Health and Development (ISPED), Bordeaux, France (C.H.); University of Bordeaux, Bordeaux, France (C.H.); INSERM, Clinical Investigation Center Clinical Epidemiology (CIC-1401), Bordeaux, France (C.H.); and INSERM, U897 (C.T., C.D.) and CIC-1401, Clinical epidemiology branch, Bordeaux Hospital (C.D.), Bordeaux University, Bordeaux, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Helmer
authors.affiliation: From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France (C.P., M.-C.P., J.-P.E.); UPMC University Paris 06, UMR-S943, Paris, France (O.G.); INSERM, UMR-S943, Paris, France (O.G.); INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (K.R.); University of Montpellier 1, Montpellier, France (K.R.); INSERM, U897, Epidemiology and Biostatistics, Institute of Public Health and Development (ISPED), Bordeaux, France (C.H.); University of Bordeaux, Bordeaux, France (C.H.); INSERM, Clinical Investigation Center Clinical Epidemiology (CIC-1401), Bordeaux, France (C.H.); and INSERM, U897 (C.T., C.D.) and CIC-1401, Clinical epidemiology branch, Bordeaux Hospital (C.D.), Bordeaux University, Bordeaux, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Empana
authors.affiliation: From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France (C.P., M.-C.P., J.-P.E.); UPMC University Paris 06, UMR-S943, Paris, France (O.G.); INSERM, UMR-S943, Paris, France (O.G.); INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (K.R.); University of Montpellier 1, Montpellier, France (K.R.); INSERM, U897, Epidemiology and Biostatistics, Institute of Public Health and Development (ISPED), Bordeaux, France (C.H.); University of Bordeaux, Bordeaux, France (C.H.); INSERM, Clinical Investigation Center Clinical Epidemiology (CIC-1401), Bordeaux, France (C.H.); and INSERM, U897 (C.T., C.D.) and CIC-1401, Clinical epidemiology branch, Bordeaux Hospital (C.D.), Bordeaux University, Bordeaux, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Tzourio
authors.affiliation: From the INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, UMR-S970, Paris, France (C.P., M.-C.P., J.-P.E.); UPMC University Paris 06, UMR-S943, Paris, France (O.G.); INSERM, UMR-S943, Paris, France (O.G.); INSERM, U1061, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France (K.R.); University of Montpellier 1, Montpellier, France (K.R.); INSERM, U897, Epidemiology and Biostatistics, Institute of Public Health and Development (ISPED), Bordeaux, France (C.H.); University of Bordeaux, Bordeaux, France (C.H.); INSERM, Clinical Investigation Center Clinical Epidemiology (CIC-1401), Bordeaux, France (C.H.); and INSERM, U897 (C.T., C.D.) and CIC-1401, Clinical epidemiology branch, Bordeaux Hospital (C.D.), Bordeaux University, Bordeaux, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Dufouil
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D014505:Urban Population
keywords: atherosclerosis; carotid arteries; depression; epidemiology; risk factors