Cardiometabolic Dysregulation Associated With Cognitive Decline Mediated by Depression

older man sad
older man sad
Depressive symptoms may mediate cognitive decline in individuals with metabolic dysregulation.

Cardiometabolic dysregulation is associated with cognitive decline, which tends to be preceded by symptoms of depression, according to a study published in The British Journal of Psychiatry.

Data from 2 large population-based cohort studies were analyzed for the current study: the Rotterdam Study and the Whitehall II study. Data were analyzed at baseline and 3 subsequent follow-ups at 4- to 6-year intervals for 2940 participants from the Rotterdam Study and 4469 participants from the Whitehall II study. The mean age of the Rotterdam participants at baseline was nearly 10 years older than Whitehall participants (age 65 and 55.2, respectively), and, though the Rotterdam individuals were 57% men and 43% women, the Whitehall participants included almost 3 times more men than women.

Both studies suggest cardiometabolic risk factors are directly associated with cognitive decline and indirectly associated through symptoms of depression, ie, cardiometabolic risk factors predict depressive symptoms 4 to 5 years later, which predict cognitive decline 4 to 6 years after that. These findings correspond to previous studies that examined associations between comorbid depression and cognitive decline in patients with diabetes. The current study adds to this knowledge by including temporality in the analysis and showing how depression could contribute to the association between cardiometabolic and cognitive functioning, eg, the poor self-care behaviors associated with depression could increase metabolic risk factors. Depression and cardiometabolic problems also share some common pathophysiological mechanisms, which may lead to increased negative impact on both conditions and an amplified risk for a decline in cognitive functioning.

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Study investigators conclude that “This has important implications for investigating the pathways that could link metabolic dysregulation and increased risk of cognitive decline. For adequate prevention of cognitive decline both cardiometabolic and mental health should play a key role.”


Schmitz N, Deschênes SS, Burns RJ, et al. Cardiometabolic dysregulation and cognitive decline: potential role of depressive symptomsBr J Psychiatry. 2018; 212(2):96-102.