Association between intracranial atherosclerosis and late-life depression: a clinicopathological study

• Grant number: 23/03110-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2023
• End date: June 30, 2024
• Field of knowledge: Health Sciences - Medicine - Pathological Anatomy and Clinical Pathology
• Principal Investigator: Alberto Fernando Oliveira Justo
• Grantee: Júlio Ken Matsubara
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Late-onset depression is a condition characterized as Major Depressive Disorder that first occurs in individuals aged 60 years or older and presents symptoms such as anhedonia and depressed mood throughout most of the day. Depression has also been recognized as an important and unconventional factor for the development of cardiovascular and cerebrovascular diseases, although it is not clear if it is a cause or consequence of these diseases. In this context, intracranial atherosclerosis is a pathological process that causes progressive stenosis and cerebral hypoperfusion, being one of the leading causes of stroke worldwide. Although there are no studies directly analyzing the relationship between intracranial atherosclerosis and depression, longitudinal prospective studies have shown that depression is associated with a twofold increase in the incidence of cardiovascular disease. Therefore, the aim of this study is to understand if there is an association between intracranial atherosclerosis and late-onset depression in the elderly. Atheroma plaques in the anterior and middle cerebral arteries will be analyzed using autopsy material from the Verification of Death Service of the Capital (SVO) of the University of São Paulo School of Medicine (FMUSP). The depression item of the Neuropsychiatric Inventory (D-NPI) will be used to assess depression, which is applied to the informant of deceased participants. The data will be analyzed through linear regression adjusted for possible confounding factors, both sociodemographic and clinical. Given the high prevalence of depression and atherosclerosis in the elderly, this topic has significant implications for public health, especially in low- and middle-income countries, where most deaths related to cardiovascular diseases occur. Understanding the risk factors and consequences of depression in the elderly is crucial for the development of effective prevention and treatment strategies, especially due to the increasing elderly population worldwide.