TOPLINE

Patients with cerebral amyloid angiopathy (CAA) were more likely to have potential depression compared with cognitively normal control individuals, and depressive symptoms partly mediated the relationship between CAA and cognitive impairment across episodic memory and executive function domains, a cross-sectional study showed.

METHODOLOGY

• A cross-sectional analysis included 85 adults with CAA (mean age, 73.5 years; 35.3% women) diagnosed using the Boston criteria version 2.0 and 83 cognitively normal control adults (mean age, 68.8 years; 62.7% women) from two Canadian centers.
• Cognitive performance was assessed across episodic memory, executive function, and processing speed using standardized neuropsychological tests, with scores converted to z-scores adjusted for age, sex, and education.
• Depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15), with scores ≥ 5 indicating potential depression.
• Mediation analyses with 1000 simulations were used to examine whether depressive symptoms mediated the effect of CAA on cognitive function. The associations between GDS-15 scores and CAA-specific MRI markers were also examined.

TAKEAWAY

• Participants with CAA had increased odds of potential depression (odds ratio [OR], 15.71; P < .001) and 2.71 times higher GDS-15 total scores compared with control individuals, despite control individuals having a higher self-reported lifetime history of depression. A greater proportion of patients with CAA met the criteria for potential depression compared with control individuals (P < .001).
• Potential depression was associated with poorer performance in episodic memory (P < .001), executive function (P < .001), and processing speed (P = .006).
• Potential depression mediated a significant proportion of the total effect of CAA on episodic memory (11%; P = .014) and executive function (9%; P = .016) but not processing speed (2%; P = .56). 
• Among CAA-related MRI markers, lower mean cortical thickness (count ratio [CR], 1.33; P = .005), presence of cortical superficial siderosis (CR, 2.04; P < .001), and higher CAA small vessel disease scores (CR, 1.16; P = .047) were associated with greater depressive symptoms.

IN PRACTICE

"Timely identification and appropriate intervention to address depressive symptoms in patients with CAA may provide improvements to cognitive function, promote patient wellbeing and quality of life, and the mitigation of other health complications," the authors wrote.

SOURCE

The study was led by Nikita Nukala, University of Calgary, Alberta, Canada. It was published online on August 5 in Neurology.

LIMITATIONS

The study was limited by its cross-sectional design, underrepresentation of individuals with current or severe depressive symptoms, lack of structured diagnostic interviews, and the absence of measures for fatigue, anxiety, apathy, or medication usage beyond antidepressants.

DISCLOSURES

The study was funded by the Canadian Institutes of Health Research, Brain Canada, Heart and Stroke Foundation of Canada, and the Alzheimer Society of Canada. Two authors reported having financial or other ties with various organizations. Details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.