Depressive Symptoms and Subclinical Vascular Disease: a Cross-Cultural Comparison
Moore, Patricia Sinclair
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While rates of depression are similar across ethnic groups, severity of symptoms and disability related to depression are greater in African Americans when compared with other groups (Breslau, Kendler, Su, Gaxiola-Aguilar, & Kessler, 2005). Markers of subclinical cardiovascular disease have been associated with depression, and rates of most cardiovascular risk factors are higher in African Americans than Caucasians (Shaya, Gu, & Saunders, 2007). Whereas rates of atherosclerosis are similar across these groups (Jain et al., 2004), atherosclerosis has been shown to be associated with depression in mostly Caucasian samples (Bus et al., 2011; Gebara & Santos, 2010). A more direct marker of subclinical cerebrovascular impact is cerebral white matter hyperintensity volume (WMHv). Differences in WMHv have been reported across ethnic groups, and WMHv is more closely associated with the cardiovascular risk factors that are higher in African Americans. White matter hyperintensities (WMH) have been independently associated with increased depressive symptoms in late-life depression (Pompili et al., 2007; 2008; Sneed et al., 2011; Tham, Woon, Sum, Lee, & Sim, 2011), although the relationship between vascular disease and depression is poorly understood. This study aimed to examine the relationship between atherosclerosis, WMHv, and depressive symptoms in Caucasians and African Americans over age 50 to determine the association between subclinical vascular disease and depressive symptoms across ethnic groups. To this end, specific measures of subclinical vascular diseases (measures of atherosclerosis, WMHv) were compared to identify the best predictors of depressive symptoms within ethnic groups.