Depression in young adulthood to midlife and brain aging in midlife: A 30‐year follow‐up of The CARDIA Study

Abstract

AbstractBackgroundEvidence suggests that depression is a risk factor for dementia in older adults, but the link between depressive symptoms and brain health earlier in life is poorly understood. We aimed to investigate the relationship between depressive symptoms in early adulthood through midlife and brain aging in midlife.MethodsFrom the prospective study of Coronary Artery Risk Development in Young Adults, we identified 649 Black and White participants (age 18‐30 at baseline) with brain MRI and cognitive testing 30 years later (mean age 55, SD 3.5). The participants underwent 6 repeated assessments for depressive symptoms measured with the Center for Epidemiological Studies Depression scale (CES‐D) over 30 years. The CES‐D range is 0‐60, a score of 16 points or more is considered depressed. Cumulative exposure of depressive symptoms was estimated by time‐weighted averages (TWA). We used a previously validated high dimensional neuroimaging pattern analysis, based on machine learning algorithms, that quantifies individual differences in age‐related atrophy using MRI‐derived structural brain characteristics. Linear regression was used to test the association between average cumulative depressive symptoms, brain aging, and cognition, adjusted chronological age, sex, race, education, intracranial volume, and scanning siteResultsEvery standard deviation (5‐points) higher average cumulative depression symptoms was associated with approximately one‐year greater brain age (Table 1). Participants with higher average cumulative depressive symptoms greater than the clinically significant cutoff of 16 points over the 30 years, had on average 3‐years greater brain age (95% CI: 0.74 to 4.96) compared to below the clinical cutoff. Adjusting for anti‐depressive medication use at any time during the follow‐up, slightly attenuated the association (Table 1).ConclusionHigher depressive symptoms across 30 years from early to mid‐adulthood are associated with accelerated brain aging in midlife. This suggests that elevated depressive symptoms in early adulthood can have implications for brain aging as early as in midlife.