Longitudinal support for the relationship between vascular risk factors and late-life depressive symptoms

Objective: The authors examined longitudinal support for the vascular depression hypothesis by assessing the extent to which baseline vascular burden was associated with depressive symptoms 6 and 18 months after discharge from inpatient medical rehabilitation. Methods: One hundred consecutive geriatric rehabilitation patients were assessed during their rehabilitation stay and subsequently screened for depression 6 and 18 months after discharge. Baseline vascular burden was entered into logistic-regression analyses predicting depression at 6 and 18 months after controlling for baseline levels of depression, general medical burden, limitations in activities of daily living, cognitive impairment, and demographic variables including age, education, gender, and race. Results: Logistic-regression results demonstrated that, after controlling for the covariates described above, baseline vascular burden was associated with increased odds of positive depression screens at 6- and 18-month follow-up assessments. Furthermore, among patients who were not depressed during their rehabilitation stay, vascular burden was predictive of positive depression screens at 6- and 18-month follow-up assessments. Conclusions: Greater vascular burden was positively associated with depressive symptoms over time. These findings provide further support for the vascular depression hypothesis in late life and highlight the need for careful clinical monitoring of this frail group of elderly patients.