Neurological
Lower retinal nerve fiber layer thickness associated with late life depression
Lower retinal nerve fiber layer (RNFL) thickness is associated with an increased risk of clinically relevant depressive symptoms and, over time, more depressive symptoms, according to study results published in JAMA Network Open.
Neurodegeneration in different brain regions can cause several symptoms associated with late life depression, including mood, cognitive, and behavioral changes. Although neurodegeneration has been suggested to contribute to depression, data on a possible association are limited.
The aim of the current study was to determine the association between a lower RNFL, a marker of neurodegeneration, with clinically relevant depressive symptoms and depressive symptoms over time.
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The population-based cohort study included patients from the general population in the Netherlands with a baseline examination between 2010 and 2020. Using the Patient Health Questionnaire (PHQ) -9, depressive symptoms were recorded at the start of the study and annually over time. The presence of clinically relevant depressive symptoms was defined as a PHQ-9 score of 10 or higher.
The study sample comprised 4934 people (mean age 59.7 years; 50.8% women) with depressive symptoms over time. During a median follow-up of 5.0 years, clinically relevant depressive symptoms were newly diagnosed in 445 participants.
After adjusting for demographic, cardiovascular, and lifestyle factors, a lower RNFL thickness was significant with a higher incidence of clinically relevant depressive symptoms (per 1 SD, hazard ratio 1.11; 95% CI, 1.01-1.23) and more depressive symptoms Connected over time (rate ratio 1.04; 95% CI 1.01-1.06).
The study had several limitations, including the use of PHQ-9 to diagnose major depressive disorder, unmeasured confounders, and a potential underestimation of the reported association due to lack of data, measurement errors, or the inability to account for antidepressant use after baseline Measurement was started.
“The present population-based cohort study found that lower RNFL thickness is associated with a higher incidence of clinically relevant depressive symptoms and more depressive symptoms over time. Therefore, neurodegeneration can contribute to the early pathobiology of late life depression, and retinal neurodegeneration monitoring can be a means of identifying individuals at risk for late life depression, ”the researchers concluded.
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van der Heide FCT, Steens ILM, Geraets AFJ, et al. Association of the thickness of the retinal nerve fiber layer, an index of neurodegeneration, with symptoms of depression over time. JAMA network open. Published online November 1, 2021. doi: 10.1001 / jamanetworkopen.2021.34753