C-reactive protein in midlife is associated with depressive symptoms two decades later among men with coronary heart disease

Abstract

Aim: We investigated the relationship between midlife C-reactive protein (CRP) levels in men with coronary heart disease (CHD) and depressive symptoms at old age. CRP levels were measured in a subset of patients with CHD, who previously participated in a secondary prevention trial.

Methods: Depressive symptoms were evaluated in survivors of the original cohort 15.0 ± 3 and 19.9 ± 1 years later (T1, n = 463 and T2, n = 314 respectively) using the Geriatric Depression Scale (GDS), 15-item version. Logistic regression was used to estimate ORs and 95%CIs for presence of potentially clinically significant depressive symptoms (GDS ≥5) at T1 and T2.

Results: Adjusting for demographic and health-related variables, the OR (95%CI) for GDS ≥5 was 1.23 (0.65–2.33); p = .53 at T1 and 2.36 (1.16–4.83); p = .018 at T2 in the top CRP tertile compared to the others. Similarly, consistently high CRP levels in the top tertile at baseline and 2 years later, were associated with OR of 2.85 (95%CI 1.29–6.30); p = .01 for GDS ≥5 at T2.

Conclusions: Presence and persistence of low-grade inflammation in men with CHD during midlife are associated with increased risk of depressive symptoms twenty years later. Among middle aged men with CHD, low-grade inflammation may provide an important added value for prediction of depression in old age.

Keywords:

• Coronary heart disease
• depression
• elderly
• inflammation

Acknowledgements

The Computerized Cognitive Battery was provided by NeuroTrax Corporation.

Disclosure statement

The authors have no conflict of interest.

Author contributions

RRS is responsible for Concept, interpretation of data and preparation of manuscript. ML is responsible for Acquisition of data, analysis and interpretation of data and preparation of manuscript. UG is responsible for Concept and design, acquisition of data and review of manuscript. MSB is responsible for Review of manuscript. DT is responsible for Concept and design, acquisition of data and review of manuscript.

Additional information

Notes on contributors

Ramit Ravona-Springer

Ramit Ravona-Springer. M.D., is a psychiatrist and director of the Memory and Geriatric Psychiatry Clinic at the Sheba Medical Center, Israel and an Assistant Professor in Psychiatry at the Sackler School of Medicine, Tel Aviv University, Israel.

Miri Lutski

Miri Lutski, PhD in Epidemiology and Preventive Medicine and works in the Israel Center for Disease Control, Ministry of Health, Israel.

Michal Schnaider Beeri

Professor Michal Schnaider Beeri, Director: Joseph Sagol Neuroscience Center, Israel; Professor, Department is Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.

Uri Goldbourt

Uri Goldbourt is a Professor of Epidemiology and Preventive Medicine at the Sackler Faculty of Medicine, Tel Aviv University, Israel.

David Tanne

David Tanne is a Professor of Neurology and directs the Stroke and Cognition Institute at the Rambam Health Care Campu; Pesident of the Israel Neurological Association.