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A dynamic view of depressive symptoms and neurocognitive change among patients with coronary artery disease

Elizabeth A Freiheit1, David B Hogan, Misha Eliasziw

  • 1Department of Community Health Sciences, University of Calgary, Third Floor Teaching Research and Wellness, Calgary.

Archives of General Psychiatry
|March 7, 2012
PubMed

Insights

Persistent depressive symptoms in older adults with coronary artery disease are linked to significant cognitive decline over 30 months. This decline may be exacerbated by the apolipoprotein E (APOE) ε4 allele.

Area of Science:

  • Cardiology
  • Geriatrics
  • Neuroscience
  • Psychiatry

Background:

  • Older patients with coronary artery disease (CAD) are susceptible to depressive symptoms and cognitive impairment.
  • The relationship between persistent depressive symptoms and cognitive decline in CAD patients is not well understood.

Purpose of the Study:

  • To investigate the association between the stability of depressive symptoms and cognitive decline over 30 months in patients undergoing coronary angiography.
  • To explore if the apolipoprotein E (APOE) ε4 allele modifies this association.

Main Methods:

  • A cohort study involving 350 patients aged 60+ undergoing nonemergent catheterization.
  • Depressive symptoms were assessed at baseline and 12 months; cognitive function was measured at baseline, 6, 12, and 30 months.
  • Cognitive domains included attention/executive function, learning/memory, verbal fluency, and global cognition (MMSE).

Main Results:

  • Persistent depressive symptoms were associated with significantly greater cognitive decline across all measured domains at 30 months.
  • This decline was evident from 12 to 30 months, even after adjusting for covariates.
  • A more pronounced decline in global cognition was observed in patients with persistent depressive symptoms and the APOE ε4 allele.

Conclusions:

  • Persistent depressive symptoms represent a significant risk factor for cognitive decline in patients with coronary artery disease.
  • The apolipoprotein E (APOE) ε4 allele may interact with depressive symptoms to accelerate cognitive decline, warranting further investigation.
Abstract

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