The role of vascular risk factors in late onset bipolar disorder

2007 ◽  
Vol 22 (8) ◽  
pp. 733-737 ◽  
Author(s):  
Hari Subramaniam ◽  
Michael S. Dennis ◽  
E. Jane Byrne
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Late Onset ◽  
Vascular Risk Factors ◽  
Vascular Risk

Treatment response in late-onset depression: relationship to neuropsychological, neuroradiological and vascular risk factors

2004 ◽  
Vol 34 (1) ◽  
pp. 125-136 ◽  
Author(s):  
R. BALDWIN ◽  
S. JEFFRIES ◽  
A. JACKSON ◽  
C. SUTCLIFFE ◽  
N. THACKER ◽  
...  
Keyword(s):  
Risk Factors ◽  
Executive Function ◽  
White Matter ◽  
Depressive Disorder ◽  
Late Onset ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Group Differences ◽  
Vascular Risk ◽  
Control Subjects

Background. Late-onset depressive disorder is associated with white matter lesions and neuropsychological deficits that in some studies are linked to a poorer outcome for depression. Some white matter lesions may be vascular in origin. This study investigated the relationship between response or non-response to antidepressant monotherapy and neuropsychological function, structural brain measures and vascular factors.Method. This was a case–control study. Fifty patients with late-onset major depressive disorder (29 who were responders to antidepressant monotherapy and 21 who were not) were compared with 35 non-depressed control subjects. Measures included assessment of vascular risk factors, neuropsychological testing and a magnetic resonance imaging (MRI) scan.Results. After adjustment for depressed mood and medication at evaluation, both patient groups had significantly more impairment compared to control subjects on verbal learning tasks involving immediate or delayed recall. Patients who did not respond to antidepressant monotherapy had significantly poorer performance than controls on tests involving visuospatial ability, language, word recognition and tests of executive function, whereas there were no differences between control subjects and responders. On two tests of executive function (verbal fluency and the Stroop test) non-responders scored significantly worse than responders. There were no significant group differences on MRI measures of atrophy or of white matter lesions apart from a higher periventricular hyperintensity score in non-responders compared to controls. There were no group differences on measures of vascular disease.Conclusion. The results lend support to the emerging evidence that resistance to treatment in late-onset depression may be associated with impaired executive function. Subtle cerebrovascular mechanisms may be involved.

scholarly journals Cognition in the First Year After a Minor Stroke, Transient Ischemic Attack, or Mimic Event and the Role of Vascular Risk Factors

2020 ◽  
Vol 11 ◽  
Author(s):  
Korinne Nicolas ◽  
Christopher Levi ◽  
Tiffany-Jane Evans ◽  
Patricia T. Michie ◽  
Parker Magin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transient Ischemic Attack ◽  
Vascular Risk Factors ◽  
Minor Stroke ◽  
First Year ◽  
Vascular Risk ◽  
Ischemic Attack ◽  
A Minor

scholarly journals Localization of white-matter lesions and effect of vascular risk factors in late-onset major depression

2009 ◽  
Vol 40 (8) ◽  
pp. 1389-1399 ◽  
Author(s):  
R. B. Dalby ◽  
M. M. Chakravarty ◽  
J. Ahdidan ◽  
L. Sørensen ◽  
J. Frandsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Major Depression ◽  
Late Onset ◽  
Brain Magnetic Resonance Imaging ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Lesion Load ◽  
Significant Difference

BackgroundSeveral studies suggest that patients with late-onset major depression (MD) have an increased load of cerebral white-matter lesions (WMLs) compared with age-matched controls. Vascular risk factors such as hypertension and smoking may confound such findings. Our aim was to investigate the association between the localization and load of WMLs in late-onset MD with respect to vascular risk factors.MethodWe examined 22 consecutive patients with late-onset first-episode MD and 22 age- and gender-matched controls using whole-brain magnetic resonance imaging (MRI). The localization, number and volume of WMLs were compared between patients and controls, while testing the effect of vascular risk factors.ResultsAmong subjects with one or more WMLs, patients displayed a significantly higher WML density in two white-matter tracts: the left superior longitudinal fasciculus and the right frontal projections of the corpus callosum. These tracts are part of circuitries essential for cognitive and emotional functions. Analyses revealed no significant difference in the total number and volume of WMLs between groups. Patients and controls showed no difference in vascular risk factors, except for smoking. Lesion load was highly correlated with smoking.ConclusionsOur results indicate that lesion localization rather than lesion load differs between patients with late-onset MD and controls. Increased lesion density in regions associated with cognitive and emotional functions may be crucial in late-onset MD, and vascular risk factors such as smoking may play an important role in the pathophysiology of late-onset MD, consistent with the vascular depression hypothesis.

Vascular risk factors in late onset mania

2002 ◽  
Vol 32 (2) ◽  
pp. 359-362 ◽  
Author(s):  
FREDERICK CASSIDY ◽  
BERNARD J. CARROLL
Keyword(s):  
Risk Factors ◽  
Psychiatric Hospitalization ◽  
Late Onset ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Cholesterol Levels ◽  
Disease Risks ◽  
Risks Factors ◽  
Bipolar Patients ◽  
Distinct Subtype

Background. Previous researches have suggested that late onset mania is a distinct subtype associated with medical and neurological disorders. Few studies, however, have focused on vascular risk factors.Methods. Records of 366 bipolar patients were reviewed and age of first psychiatric hospitalization determined. Late-onset cases were determined empirically from a distribution histogram. Late onset cases were matched to early onset cases and histories of vascular disease/risks and current cholesterol levels compared.Results. The distribution of age of first psychiatric hospitalization was bimodal with an intermode at age 47. Using that threshold, 6·3% of the cohort was classified as having late onset mania. Vascular risks factors were greater and current cholesterol levels higher in the late onset group.Conclusions. Late onset mania is associated with greater vascular risk factors. The bimodal appearance of age of first psychiatric hospitalization in this study provides further support of late onset mania as a distinct manic subtype with possibly a different, vascular aetiology. Control of these vascular risks may impact on the incidence of late onset mania, as well as on its clinical management.

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