Format

Send to

Choose Destination
Br J Psychiatry. 2019 Apr;214(4):230-236. doi: 10.1192/bjp.2018.288. Epub 2019 Jan 4.

The association between frontal lobe perfusion and depressive symptoms in later life.

Author information

1
Research Fellow, The Irish Longitudinal Study on Ageing,Trinity College Dublin;Mercer's Institute for Successful Ageing,St James's Hospital; andAge-related Health Care,Tallaght Hospital,Ireland.
2
Biostatistician, The Irish Longitudinal Study on Ageing,Trinity College Dublin,Ireland.
3
Registrar in Geriatric Medicine, Mercer's Institute for Successful Ageing,St James's Hospital,Ireland.
4
Research Fellow, The Irish Longitudinal Study on Ageing,Trinity College Dublin; andMercer's Institute for Successful Ageing,St James's Hospital,Ireland.
5
Bioengineer, The Irish Longitudinal Study on Ageing,Trinity College Dublin,Ireland.
6
Consultant Geriatrician, Age-related Health Care,Tallaght Hospital,Ireland.
7
Consultant Geriatrician, The Irish Longitudinal Study on Ageing,Trinity College Dublin; andMercer's Institute for Successful Ageing,St James's Hospital,Ireland.

Abstract

BACKGROUND:

Deficits in frontal lobe perfusion have been demonstrated in late-life depression; however, studies to date have generally involved small numbers, used neuroimaging rather than bedside testing and have not controlled for important covariates.AimsWe aimed to examine the association between depressive symptoms and frontal lobe perfusion during standing, in a large cohort of community-dwelling older people.

METHOD:

Participants aged ≥50 years underwent continuous measurement of orthostatic blood pressure by finometry, and frontal lobe perfusion by near-infrared spectroscopy. Depressive symptoms were assessed by the eight-item Centre for Epidemiological Studies Depression Scale. Real-time frontal lobe cerebral oxygenation was measured by the Portalite System, detecting changes in frontal lobe perfusion and reporting a tissue saturation index score.

RESULTS:

Almost 8% (209 out of 2616) had clinically significant depressive symptoms. Multilevel models demonstrated a significantly lower tissue saturation index in participants with depressive symptoms at both 60 and 90 s post-stand, with coefficients of -0.43 (95% CI -0.63 to -0.22) and -0.37 (95% CI -0.57 to -0.16), respectively. Controlling for relevant covariates did not significantly attenuate these associations. After addition of systolic blood pressure this association was no longer significant, suggesting lower blood pressure may modify this relationship.

CONCLUSIONS:

This study demonstrates that lower frontal lobe perfusion, related to lower values of baseline systolic blood pressure, is associated with clinically significant depressive symptoms in a cohort of community-dwelling older people. Given the recognised longitudinal association between lower blood pressure and depression in older people, this may represent a potential therapeutic target for prevention of incident depression.Declaration of interestNone.

KEYWORDS:

Depression; blood pressure; cerebral perfusion; frontal lobe; older

PMID:
30606275
DOI:
10.1192/bjp.2018.288

Supplemental Content

Full text links

Icon for Cambridge University Press
Loading ...
Support Center