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Kochlik B, Herpich C, Moreno-Villanueva M, Klaus S, Müller-Werdan U, Weinberger B, Fiegl S, Toussaint O, Debacq-Chainiaux F, Schön C, Bernhard J, Breusing N, Gonos ES, Franceschi C, Capri M, Sikora E, Hervonen A, Hurme M, Slagboom PE, Dollé MET, Jansen E, Grune T, Bürkle A, Norman K. Associations of circulating GDF15 with combined cognitive frailty and depression in older adults of the MARK-AGE study. GeroScience 2024; 46:1657-1669. [PMID: 37715843 PMCID: PMC10828354 DOI: 10.1007/s11357-023-00902-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/31/2023] [Indexed: 09/18/2023] Open
Abstract
Growth differentiation factor-15 (GDF15) might be involved in the development of cognitive frailty and depression. Therefore, we evaluated cross-sectional associations of plasma GDF15 with combined cognitive-frailty-and-depression in older (i.e. ≥ 55 years) and younger adults of the MARK-AGE study. In the present work, samples and data of MARK-AGE ("European study to establish bioMARKers of human AGEing") participants (N = 2736) were analyzed. Cognitive frailty was determined by the global cognitive functioning score (GCF) and depression by the Self-Rating Depression Scale (SDS score). Adults were classified into three groups: (I) neither-cognitive-frailty-nor-depression, (II) either-cognitive-frailty-or-depression or (III) both-cognitive-frailty-and-depression. Cross-sectional associations were determined by unadjusted and by age, BMI, sex, comorbidities and hsCRP-adjusted linear and logistic regression analyses. Cognitive frailty, depression, age and GDF15 were significantly related within the whole study sample. High GDF15 levels were significantly associated with both-cognitive-frailty-and-depression (adjusted β = 0.177 [0.044 - 0.310], p = 0.009), and with low GCF scores and high SDS scores. High GDF15 concentrations and quartiles were significantly associated with higher odds to have both-cognitive-frailty-and-depression (adjusted odds ratio = 2.353 [1.267 - 4.372], p = 0.007; and adjusted odds ratio = 1.414 [1.025 - 1.951], p = 0.035, respectively) independent of age, BMI, sex, comorbidities and hsCRP. These associations remained significant when evaluating older adults. We conclude that plasma GDF15 concentrations are significantly associated with combined cognitive-frailty-and-depression status and, with cognitive frailty and depressive symptoms separately in old as well as young community-dwelling adults.
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Affiliation(s)
- Bastian Kochlik
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Food4Future (F4F), c/o Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Theodor-Echtermeyer-Weg 1, 14979, Grossbeeren, Germany
| | - Catrin Herpich
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam , Potsdam, Germany
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - María Moreno-Villanueva
- Molecular Toxicology Group, Department of Biology, University of Konstanz, Constance, Germany
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, Constance, Germany
| | - Susanne Klaus
- Institute of Nutritional Science, University of Potsdam , Potsdam, Germany
- Department of Physiology of Energy Metabolism, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Ursula Müller-Werdan
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
- Protestant Geriatric Center Berlin (EGZB), Berlin, Germany
| | - Birgit Weinberger
- Research Institute for Biomedical Aging Research, Universität Innsbruck, Rennweg 10, 6020, Innsbruck, Austria
| | - Simone Fiegl
- UMIT TIROL, Eduard-Wallnöfer-Zentrum 1, 6060, Hall in Tirol, Austria
| | - Olivier Toussaint
- URBC-Narilis, University of Namur, Rue de Bruxelles 61, B-5000, Namur, Belgium
| | | | | | - Jürgen Bernhard
- BioTeSys GmbH, Schelztorstraße 54-56, 73728, Esslingen, Germany
| | - Nicolle Breusing
- Institute of Nutritional Medicine, Department of Applied Nutritional Science/Dietetics, University of Hohenheim, Stuttgart, Germany
| | - Efstathios S Gonos
- Institute of Biological Research and Biotechnology, National Hellenic Research Foundation (NHRF, 48 Vas. Constantinou Ave, 11635, Athens, Greece
| | - Claudio Franceschi
- Institute of Information Technology, Mathematics and Mechanics, Department of Applied Mathematics, National Research Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
| | - Miriam Capri
- Department of Medical and Surgical Sciences, University of Bologna-Alma Mater Studiorum, Bologna, Italy
- Alma Mater Research Institute On Global Challenges and Climate Change (Alma Climate), University of Bologna, Bologna, Italy
| | - Ewa Sikora
- Laboratory of the Molecular Bases of Ageing, Polish Academy of Sciences, Nencki Institute of Experimental Biology, Warsaw, Poland
| | - Antti Hervonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Mikko Hurme
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - P Eline Slagboom
- Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martijn E T Dollé
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Eugene Jansen
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Tilman Grune
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam , Potsdam, Germany
- Faculty of Chemistry, Department of Physiological Chemistry, University of Vienna, Vienna, Austria
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Alexander Bürkle
- Molecular Toxicology Group, Department of Biology, University of Konstanz, Constance, Germany
| | - Kristina Norman
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany.
- Institute of Nutritional Science, University of Potsdam , Potsdam, Germany.
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.
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Lugtenburg A, Zuidersma M, Rius Ottenheim N, Rhebergen D, Oude Voshaar RC. Age-related subtypes of late life depression and mortality: A prospective clinical cohort study. Int J Geriatr Psychiatry 2024; 39:e6064. [PMID: 38342779 DOI: 10.1002/gps.6064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/27/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVES Late Life Depression (LLD) is associated with increased mortality rates, but it remains unclear which depressed patients are at increased risk. This study examined the mortality risk of previously identified subgroups of depressed older patients based on age-related clinical features (the presence of physical and cognitive frailty). METHODS A six-year follow-up of a clinical cohort study including 375 depressed older patients and 132 non-depressed persons (NESDO). Depressed patients were diagnosed with the Composite International Diagnostic Interview (CIDI) according to DSM-IV criteria and classified by latent profile analysis on depressive symptom severity, cognitive domains and physical frailty. We estimated the hazard rate of mortality for the four depressed subgroups compared to non-depressed persons by applying Cox-regression analyses. Models were adjusted for age, sex and education as confounders and for explanatory variables per pathway in separate models: somatic burden, lifestyle characteristics, vascular burden or inflammation markers. RESULTS A total of 61/375 (16.3%) depressed patients and 8/132 (6.1%) non-depressed persons died during the 6-year follow-up. Two of the four subgroups (n = 186/375 (50%) of the depressed sample) had a higher hazard rate (HR) for mortality compared to non-depressed participants, that is, frail-depressed patients (HR = 5.25, [95%-CI: 2.13-13.0]) and pure mild depressed patients (HR = 3.32 [95%-CI: 1.46-7.58]) adjusted for confounders. Adding possible underlying pathways did not explain these associations. CONCLUSIONS Age-related features (the presence of physical and cognitive frailty) contribute to the increased mortality risk in late-life depression. Future studies in depressed older patients should study the additional value of a clinical geriatric assessment and integrated treatment aimed to at reduce frailty and ameliorate their mortality risk.
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Affiliation(s)
- Astrid Lugtenburg
- Department Old Age Psychiatry, GGZ Drenthe Mental Health Institute, Assen, The Netherlands
| | - Marij Zuidersma
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, Netherlands
| | | | - Didi Rhebergen
- Department of Psychiatry, Amsterdam UMC-Location VU University Medical Center & GGZ Centraal Specialized Mental Health Care, Amersfoort, The Netherlands
| | - Richard C Oude Voshaar
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, Netherlands
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Mastrobattista E, Lenze EJ, Reynolds CF, Mulsant BH, Wetherell J, Wu GF, Blumberger DM, Karp JF, Butters MA, Mendes-Silva AP, Vieira EL, Tseng G, Diniz BS. Late-Life Depression is Associated With Increased Levels of GDF-15, a Pro-Aging Mitokine. Am J Geriatr Psychiatry 2023; 31:1-9. [PMID: 36153290 PMCID: PMC9701166 DOI: 10.1016/j.jagp.2022.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/14/2022] [Accepted: 08/18/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE In older adults, major depressive disorder (MDD) is associated with accelerated physiological and cognitive aging, generating interest in uncovering biological pathways that may be targetable by interventions. Growth differentiation factor-15 (GDF-15) plays a significant role in biological aging via multiple biological pathways relevant to age and age-related diseases. Elevated levels of GDF-15 correlate with increasing chronological age, decreased telomerase activity, and increased mortality risk in older adults. We sought to evaluate the circulating levels of GDF-15 in older adults with MDD and its association with depression severity, physical comorbidity burden, age of onset of first depressive episode, and cognitive performance. DESIGN This study assayed circulating levels of GDF-15 in 393 older adults (mean ± SD age 70 ± 6.6 years, male:female ratio 1:1.54), 308 with MDD and 85 non-depressed comparison individuals. RESULTS After adjusting for confounding variables, depressed older adults had significantly higher GDF-15 serum levels (640.1 ± 501.5 ng/mL) than comparison individuals (431.90 ± 223.35 ng/mL) (t=3.75, d.f.= 391, p=0.0002). Among depressed individuals, those with high GDF-15 had higher levels of comorbid physical illness, lower executive cognitive functioning, and higher likelihood of having late-onset depression. CONCLUSION Our results suggest that depression in late life is associated with GDF-15, a marker of amplified age-related biological changes. GDF-15 is a novel and potentially targetable biological pathway between depression and accelerated aging, including cognitive aging.
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Affiliation(s)
| | - Eric J Lenze
- Department of Psychiatry (EJL), Washington University School of Medicine, St Louis, MO
| | - Charles F Reynolds
- Department of Psychiatry (CFR, MAB), University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Benoit H Mulsant
- Department of Psychiatry (BHM, DMB, APMS, ELV), Temerty Faculty of Medicine, University of Toronto, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Julie Wetherell
- VA San Diego Healthcare System (JW), Mental Health Impact Unit 3, University of California, San Diego Department of Psychiatry
| | - Gregory F Wu
- Department of Neurology (GFW), Washington University, St Louis, MO
| | - Daniel M Blumberger
- Department of Psychiatry (BHM, DMB, APMS, ELV), Temerty Faculty of Medicine, University of Toronto, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Jordan F Karp
- Department of Psychiatry (JFK), The University of Arizona College of Medicine, Tucson, AZ
| | - Meryl A Butters
- Department of Psychiatry (CFR, MAB), University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Ana Paula Mendes-Silva
- Department of Psychiatry (BHM, DMB, APMS, ELV), Temerty Faculty of Medicine, University of Toronto, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Erica L Vieira
- Department of Psychiatry (BHM, DMB, APMS, ELV), Temerty Faculty of Medicine, University of Toronto, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - George Tseng
- Department of Biostatistics (GT), University of Pittsburgh School of Public Health, PA
| | - Breno S Diniz
- UConn Center on Aging (EM, BSD), University of Connecticut, Farmington, CT; Department of Psychiatry (BSD), UConn School of Medicine, Farmington, CT.
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Kokkeler KJE, Marijnissen RM, Wardenaar KJ, Rhebergen D, van den Brink RHS, van der Mast RC, Oude Voshaar RC. Subtyping late-life depression according to inflammatory and metabolic dysregulation: a prospective study. Psychol Med 2022; 52:515-525. [PMID: 32618234 PMCID: PMC8883765 DOI: 10.1017/s0033291720002159] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 05/22/2020] [Accepted: 06/03/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Inflammation and metabolic dysregulation are age-related physiological changes and are associated with depressive disorder. We tried to identify subgroups of depressed older patients based on their metabolic-inflammatory profile and examined the course of depression for these subgroups. METHODS This clinical cohort study was conducted in a sample of 364 depressed older (⩾60 years) patients according to DSM-IV criteria. Severity of depressive symptoms was monitored every 6 months and a formal diagnostic interview repeated at 2-year follow-up. Latent class analyses based on baseline metabolic and inflammatory biomarkers were performed. Adjusted for confounders, we compared remission of depression at 2-year follow-up between the metabolic-inflammatory subgroups with logistic regression and the course of depression severity over 2-years by linear mixed models. RESULTS We identified a 'healthy' subgroup (n = 181, 49.7%) and five subgroups characterized by different profiles of metabolic-inflammatory dysregulation. Compared to the healthy subgroup, patients in the subgroup with mild 'metabolic and inflammatory dysregulation' (n = 137, 37.6%) had higher depressive symptom scores, a lower rate of improvement in the first year, and were less likely to be remitted after 2-years [OR 0.49 (95% CI 0.26-0.91)]. The four smaller subgroups characterized by a more specific immune-inflammatory dysregulation profile did not differ from the two main subgroups regarding the course of depression. CONCLUSIONS Nearly half of the patients with late-life depressions suffer from metabolic-inflammatory dysregulation, which is also associated with more severe depression and a worse prognosis. Future studies should examine whether these depressed older patients benefit from a metabolic-inflammatory targeted treatment.
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Affiliation(s)
- K. J. E. Kokkeler
- Department of Old Age Psychiatry, ProPersona, Arnhem, Wolfheze, The Netherlands
- University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - R. M. Marijnissen
- University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - K. J. Wardenaar
- University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - D. Rhebergen
- Department Psychiatry, GGZinGeest, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - R. H. S. van den Brink
- University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - R. C. van der Mast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychiatry, CAPRI-University of Antwerp, Antwerp, Belgium
| | - R. C. Oude Voshaar
- University Center of Psychiatry & Interdisciplinary Center for Psychopathology of Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Associations between Sex Hormones and Circulating Growth Differentiation Factor-15 in Male Patients with Major Depressive Disorder. Brain Sci 2021; 11:brainsci11121612. [PMID: 34942914 PMCID: PMC8699823 DOI: 10.3390/brainsci11121612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/22/2021] [Accepted: 12/01/2021] [Indexed: 12/27/2022] Open
Abstract
The interaction between the endocrine system and inflammation is crucial pathogenesis of depression. Our study aimed at exploring the possible relationship between sex hormones and growth differentiation factor-15 (GDF-15), a common indicator of inflammation in male patients with major depressive disorder (MDD). Methods: GDF-15 levels of 121 male MDD patients were compared with 105 healthy subjects with the help of a Cobas 8000 automatic chemiluminescence immunoanalyzer. Results: (1) MDD patients showed higher GDF-15 levels, a lower testosterone (T) level and testosterone/estradiol ratio (T/E2 ratio) than healthy subjects (all p < 0.05). (2) Serum T levels and the T/E2 ratio were inversely associated with GDF-15 serum levels (all p < 0.05). (3) HAMD-24 scores were positively correlated with the levels of GDF-15 (p < 0.01), but not with T levels, estradiol (E2) levels, and the T/E2 ratio (all p > 0.05). Conclusion: The high level of GDF-15 was correlated with a low T/E2 ratio and T deficiency in male MDD patients. The above results demonstrate that up-regulation of serum GDF-15 and down-regulation of T and T/E2 ratio may be correlated with the occurrence and severity of depression. So, changing the level of GDF-15 by regulating the proportion of sex hormones may play a key role in the prognosis and treatment of depression.
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Lu X, Duan J, Cheng Q, Lu J. The association between serum growth differentiation factor-15 and 3-month depression after acute ischemic stroke. J Affect Disord 2020; 260:695-702. [PMID: 31561112 DOI: 10.1016/j.jad.2019.09.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/17/2019] [Accepted: 09/08/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this study was to assess the association between serum growth differentiation factor-15(GDF-15) and 3-month depression after acute ischemic stroke. METHODS In this single-center prospective study, patients with first-ever acute ischemic stroke between March 2017 and November 2018 were included. Neurological and neuropsychological evaluations were conducted during the 3-month follow-up. The predictive value of GDF-15 to predict the post-stroke depression (PSD) within 3 months, was compared with other known predictors. RESULTS The median level of GDF-15 in 310 stroke patients was 1285(IQR, 846-1934) ng/l. During the 3-month follow-up, 76 patients were defined as depression (24.5%; 95% confidence interval [CI]: 17.9%-29.3%), and GDF-15 levels in those patients were nearly more than 1 time greater as compared with patients who were free of depression (P < 0.001). Using the ROC curves, GDF-15 serum level at 1660 ng/l predicted the PSD with the highest sensitivity and specificity [67.1% and 77.4%, respectively; AUC=0.78, 95%CI: 0.72-0.84; P < 0.001]. Interestingly, When GDF-15 was added to the model containing established significant risk factors, AUROC (standard error) was increased from 0.81(0.029) to 0.88(0.020). A significant difference in the AUC between the established risk factors alone and the addition of GDF-15 was observed (difference, 0.07[0.009]; P = 0.001). In a multivariate model using the elevated levels of GDF-15 (≥cut-off=1660 ng/l) vs. normal (<cut-off) together with the other significant clinical variables, the marker displayed predictive information (PSD: OR = 4.11 [95% CI, 2.05-6.32]; P < 0.001]). CONCLUSIONS In summary, GDF-15 serum levels at admission are associated with depression later developed in patients with ischemic stroke.
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Affiliation(s)
- Xiurong Lu
- Department of Neurology, Central Hospital of Zhoukou, No. 26, Renmin Road, Zhoukou, 646000, Henan Province, PR China.
| | - Jinfeng Duan
- Department of Psychiatry, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, PR China
| | - Qian Cheng
- Department of Neurology, Central Hospital of Zhoukou, No. 26, Renmin Road, Zhoukou, 646000, Henan Province, PR China
| | - Junli Lu
- Department of Anus and Bowel, Central Hospital of Zhoukou, Zhoukou, PR China
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Rozing MP, Veerhuis R, Westendorp RGJ, Eikelenboom P, Stek M, Marijnissen RM, Oude Voshaar RC, Comijs HC, van Exel E. Inflammation in older subjects with early- and late-onset depression in the NESDO study: a cross-sectional and longitudinal case-only design. Psychoneuroendocrinology 2019; 99:20-27. [PMID: 30172071 DOI: 10.1016/j.psyneuen.2018.08.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 08/18/2018] [Accepted: 08/22/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Different biological mechanisms may underlie depression beginning in early life (early-onset) and depression beginning later in life (late-onset). Although the relation between inflammation and depression has been studied extensively, the distinct role of inflammation in early and late-onset depression in older patients has not been addressed before. In the cross-sectional part of this study, we explored differences in levels of circulating inflammatory markers and cytokine levels in lipopolysaccharide (LPS) stimulated whole blood between older subjects with a late-life onset depression (≥60 years) and older subjects with an early-onset depression (<60 years). Secondly, in a 2-year follow-up study, we examined if circulating and stimulated inflammatory markers influenced the change in Inventory of Depressive Symptomatology (IDS) scores, and if this relation was different for early- and late-onset depression. METHODS The study was part of the Netherlands Study of Depression in Older Persons (NESDO). We included 350 patients, all aged 60 and older, with a depressive episode in the previous 6 months: 119 with a late-onset depression and 231 with an early-onset depression. Blood samples were collected and CRP, IL-6, NGAL, GDF15, and, LPS plasma levels were determined and whole blood was LPS stimulated and cytokine levels IL-1β, IL-6, TNFα, IFNγ, IL-10, and IL-1 receptor antagonist (IL-1ra) were determined. RESULTS After adjustment for demographics, health indicators, and medication use, increased plasma CRP levels were more strongly associated with late-onset depression than early-onset depression (OR [95% CI]: 1.43 [1.05-1.94]). In the longitudinal analyses, higher circulating IL-6 levels were associated with a significantly slower decline in IDS scores in the crude and the adjusted models (p ≤ 0.027). This relation was not different between late- and early-onset depression. Other circulating and stimulated inflammatory markers were not associated with late- and/or early-onset depression. CONCLUSIONS This study provides preliminary evidence that low-grade inflammation is more strongly associated with late-onset than early-onset depression in older adults, suggesting a distinct inflammatory etiology for late-onset depression. Cytokine production capacity did not distinguish between early- and late-onset depression.
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Affiliation(s)
- M P Rozing
- Department of Public Health, section Epidemiology, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark; The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - R Veerhuis
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest / Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - R G J Westendorp
- Department of Public Health, section Epidemiology, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - P Eikelenboom
- Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest / Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - M Stek
- Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest / Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - R M Marijnissen
- University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Old Age Psychiatry, ProPersona, Arnhem/Wolfheze, The Netherlands
| | - R C Oude Voshaar
- University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - H C Comijs
- Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest / Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - E van Exel
- Amsterdam UMC, Vrije Universiteit Amsterdam, GGZ inGeest / Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Ng A, Tam WW, Zhang MW, Ho CS, Husain SF, McIntyre RS, Ho RC. IL-1β, IL-6, TNF- α and CRP in Elderly Patients with Depression or Alzheimer's disease: Systematic Review and Meta-Analysis. Sci Rep 2018; 8:12050. [PMID: 30104698 PMCID: PMC6089986 DOI: 10.1038/s41598-018-30487-6] [Citation(s) in RCA: 356] [Impact Index Per Article: 59.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 08/01/2018] [Indexed: 12/15/2022] Open
Abstract
We carried out systematic review and meta-analysis to evaluate whether peripheral levels of pro-inflammatory markers including Interleukin-1 beta (IL-1β), Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF- α) and C-Reactive Protein (CRP) are significantly higher in elderly with depression and Alzheimer's disease. We searched Pubmed, PsycINFO and Embase, and thirty-four relevant studies (2609 with Depression, 1645 with Alzheimer's disease and 14363 Controls) were included. Compared with controls, IL-1β (pooled standardized mean difference [SMD]: 0.642; 95% confidence interval [CI]: 0.078-1.206; significant heterogeneity: I2 = 86.28%) and IL-6 (pooled SMD: 0.377; 95% CI: 0.156-0.598; significant heterogeneity: I2 = 88.75%) were significantly elevated in depression. There was no difference in TNF-α (p = 0.351) and CRP (p = 0.05) between those with depression and controls. Compared with controls, IL-1β (pooled SMD: 1.37, 95% CI: 0.06-2.68, significant heterogeneity: I2 = 96.01%) was significantly elevated in Alzheimer's disease. There were no differences in IL-6 (p = 0.138), TNF-α (p = 0.451) and CRP (p = 0.07) between elderly with Alzheimer's disease and controls. After Bonferroni adjustment, only IL-6 remained significantly higher in depression. Elderly with depression have higher IL-6 than controls, while those with Alzheimer's disease did not have higher peripheral inflammatory markers.
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Affiliation(s)
- Ada Ng
- Department of Internal Medicine, National University Health System, Singapore, Singapore
| | - Wilson W Tam
- Alice Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Melvyn W Zhang
- Biomedical Institute for Global Health Research and Technology, National University of Singapore, Singapore, Singapore
| | - Cyrus S Ho
- Department of Psychological Medicine, National University Health System, Singapore, Singapore.
| | - Syeda F Husain
- Biomedical Institute for Global Health Research and Technology, National University of Singapore, Singapore, Singapore
| | - Roger S McIntyre
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Toxicology and Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Roger C Ho
- Department of Internal Medicine, National University Health System, Singapore, Singapore
- Biomedical Institute for Global Health Research and Technology, National University of Singapore, Singapore, Singapore
- Department of Psychological Medicine, National University Health System, Singapore, Singapore
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9
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Kumar P, Millischer V, Villaescusa JC, Nilsson IAK, Östenson CG, Schalling M, Ösby U, Lavebratt C. Plasma GDF15 level is elevated in psychosis and inversely correlated with severity. Sci Rep 2017; 7:7906. [PMID: 28801589 PMCID: PMC5554200 DOI: 10.1038/s41598-017-07503-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/27/2017] [Indexed: 12/20/2022] Open
Abstract
Accumulating evidence suggests that GDF15 is a biomarker for ageing and morbidity of many somatic disorders such as cancer and inflammatory disorders. Recently, elevated serum GDF15 level was proposed as a marker for mood disorder. However, psychosis severity was not investigated in relation to plasma GDF15 levels. In the present study we measured GDF15 levels in plasma of 120 psychosis patients compared to 120 age and gender matched healthy controls. Within the patient cohort GDF15 levels were evaluated for association with age, gender, lifestyle factors, C-reactive protein levels, psychosis severity and metabolic disorder. Psychosis patients had elevated GDF15 levels compared to controls (medianPsychosis = 744 ng/mL, mediancontrols = 516 ng/mL, p < 0.001). Within the psychosis cohort, GDF15 levels, when corrected for age, metabolic health and lifestyle factors, were negatively correlated with psychosis severity (β = −0.218, p = 0.012). While GDF15 levels were elevated in patients versus healthy controls, the negative correlation between psychosis severity and GDF15 suggests a loss of anti-inflammatory GDF15 mediated functionality in severe psychosis. Study replication in larger cohorts will be necessary to assess the potential of GDF15 as a prognostic biomarker in psychosis.
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Affiliation(s)
- Parvin Kumar
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. .,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
| | - Vincent Millischer
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - J Carlos Villaescusa
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ida A K Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Claes-Göran Östenson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Urban Ösby
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Adult Psychiatry, PRIMA Barn och Vuxenpsykiatri AB, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. .,Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.
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