Department of Clinical and Health Psychology, The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA.
The Center for Cognitive Aging and Memory, University of Florida, Gainesville, Florida, USA.
J Gerontol B Psychol Sci Soc Sci. 2024 Apr 1;79(4). doi: 10.1093/geronb/gbae009.
Late-life depression and white matter hyperintensities (WMH) have been linked to increased dementia risk. However, there is a dearth of literature examining these relationships in Black adults. We investigated whether depression or WMH volume are associated with a higher likelihood of dementia diagnosis in a sample of late middle-aged to older Black adults, and whether dementia prevalence is highest in individuals with both depression and higher WMH volume.
Secondary data analysis involved 443 Black participants aged 55+ with brain imaging within 1 year of baseline visit in the National Alzheimer's Coordinating Center Uniform Data Set. Chi-square analyses and logistic regression models controlling for demographic variables examined whether active depression in the past 2 years, WMH volume, or their combination were associated with higher odds of all-cause dementia.
Depression and higher WMH volume were associated with a higher prevalence of dementia. These associations remained after controlling for demographic factors, as well as vascular disease burden. Dementia risk was highest in the depression/high WMH volume group compared to the depression-only group, high WMH volume-only group, and the no depression/low WMH volume group. Post hoc analyses comparing the Black sample to a demographically matched non-Hispanic White sample showed associations of depression and the combination of depression and higher WMH burden with dementia were greater in Black compared to non-Hispanic White individuals.
Results suggest late-life depression and WMH have independent and joint relationships with dementia and that Black individuals may be particularly at risk due to these factors.
晚年抑郁症和脑白质高信号（WMH）与痴呆风险增加有关。然而，关于黑人群体中这些关系的文献却很少。我们研究了在一组中老年黑人样本中，抑郁或 WMH 体积是否与痴呆诊断的可能性增加有关，以及是否在同时存在抑郁和更高 WMH 体积的个体中痴呆的患病率最高。
二次数据分析涉及了国家阿尔茨海默病协调中心统一数据集中的 443 名年龄在 55 岁以上、在基线检查后一年内有脑部成像的黑人参与者。卡方分析和逻辑回归模型控制了人口统计学变量，以检验过去 2 年是否存在活跃性抑郁、WMH 体积或两者的组合与全因痴呆的更高几率有关。
抑郁和更高的 WMH 体积与痴呆的更高患病率有关。这些关联在控制了人口统计学因素以及血管疾病负担后仍然存在。与仅抑郁组、仅高 WMH 体积组和无抑郁/低 WMH 体积组相比，抑郁/高 WMH 体积组的痴呆风险最高。与在人口统计学上匹配的非西班牙裔白人样本相比的事后分析表明，抑郁和抑郁与更高 WMH 负担的组合与痴呆的关联在黑人中比非西班牙裔白人中更大。
结果表明，晚年抑郁症和 WMH 与痴呆有独立和共同的关系，而黑人个体可能由于这些因素而特别处于风险之中。
