Aortic Stiffness, White Matter Integrity and Depressive Symptoms among Older Adults [thesis]

Jingkai Wei
Aortic stiffness is a hallmark of aging and is associated with neurocognitive outcomes among older adults. Late-life depression, often associated with structural damage in cerebral white matter integrity, is an important public health burden. This doctoral research examined the associations of aortic stiffness with white matter microstructural integrity and depressive symptoms among older adults. Methods: Data from the 5th and 6th examinations of the Atherosclerosis Risk in Communities cohort
more » ... 011-2013, 2016-2018) were analyzed. A total of 1,484 participants (aged 67 to 90 years) were included in the analysis of aortic stiffness and white matter microstructural integrity, and 4,511 participants (aged 66 to 90 years) were included in the analysis on aortic stiffness and depressive symptoms. Aortic stiffness was measured as carotid-femoral pulse wave velocity (cfPWV). Cerebral white matter microstructural integrity was measured as fractional anisotropy (FA) and mean diffusivity (MD) using diffusion tensor imaging. Depressive symptoms were assessed using the 11-item Centers for Epidemiologic Studies-Depression (CES-D) Scale. A CES-D score ≥9 was considered indicative of clinically significant depressive symptoms (CSDS). Results: Relating aortic stiffness and white matter microstructural integrity, each 1 m/s increment in cfPWV was associated with lower overall FA (β=-0.03, 95% confidence interval (CI): -0.05, -0.02) and higher overall MD (β=0.03, 95% CI: 0.02, 0.04). Elevated cfPWV (upper 25thpercentile) was associated with lower FA (β=-0.26, 95% CI: -0.39, -0.14) and higher overall MD (β=0.21, 95% CI: 0.11, 0.32). Similar associations were observed at individual cerebral regions of interest. In cross-sectional analyses of aortic stiffness and depressive symptoms we observed a positive association of elevated cfPWV with the greater CES-D score (standardized beta (β)=0.07, 95% CI: 0.004, 0.15) and greater odds of CSDS (odds ratio (OR)=1.37, 95% CI: 1.01, 1.85). No as [...]
doi:10.17615/341g-tw67 fatcat:a6f25lwvdjggvewi7nzfbkh5ey