TY - JOUR
T1 - Association of Retinal Nerve Fiber Layer Thickness, an Index of Neurodegeneration, With Depressive Symptoms Over Time
AU - van der Heide, Frank C T
AU - Steens, Indra L M
AU - Geraets, Anouk F J
AU - Foreman, Yuri D
AU - Henry, Ronald M A
AU - Kroon, Abraham A
AU - van der Kallen, Carla J H
AU - van Sloten, Thomas T
AU - Dagnelie, Pieter C
AU - van Dongen, Martien C J M
AU - Eussen, Simone J P M
AU - Berendschot, Tos T J M
AU - Schouten, Jan S A G
AU - Webers, Carroll A B
AU - van Greevenbroek, Marleen M J
AU - Wesselius, Anke
AU - Koster, Annemarie
AU - Schaper, Nicolaas C
AU - Schram, Miranda T
AU - Köhler, Seb
AU - Stehouwer, Coen D A
N1 - Publisher Copyright:
© 2021 van der Heide FCT et al.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - IMPORTANCE: Whether neurodegeneration contributes to the early pathobiology of late-life depression remains incompletely understood.OBJECTIVE: To investigate whether lower retinal nerve fiber layer (RNFL) thickness, a marker of neurodegeneration, is associated with the incidence of clinically relevant depressive symptoms and depressive symptoms over time.DESIGN, SETTING, AND PARTICIPANTS: This is a population-based cohort study from the Netherlands (The Maastricht Study) with baseline examination between 2010 and 2020 and median (IQR) follow-up of 5.0 (3.0-6.0) years. Participants were recruited from the general population. Individuals with type 2 diabetes were oversampled by design. Data analysis was performed from September 2020 to January 2021.EXPOSURES: RNFL, an index of neurodegeneration, assessed with optical coherence tomography.MAIN OUTCOMES AND MEASURES: Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ)-9 (continuous score, 0-27) at baseline and over time via annual assessments. The presence of clinically relevant depressive symptoms was defined as a PHQ-9 score of 10 or higher.RESULTS: We used data from 4934 participants with depressive symptoms over time (mean [SD] age, 59.7 [8.4] years; 2159 women [50.8%]; 870 had type 2 diabetes [20.5%]). Lower RNFL thickness was associated with higher incidence of clinically relevant depressive symptoms (per 1 SD, hazard ratio 1.11; 95% CI, 1.01-1.23) and more depressive symptoms over time (per 1 SD, rate ratio, 1.04; 95% CI, 1.01-1.06), after adjustment for demographic, cardiovascular, and lifestyle factors.CONCLUSIONS AND RELEVANCE: The findings of this study suggest that lower RNFL thickness is associated with higher incidence of clinically relevant depressive symptoms and more depressive symptoms over time. Hence, neurodegeneration may be associated with the early pathobiology of late-life depression.
AB - IMPORTANCE: Whether neurodegeneration contributes to the early pathobiology of late-life depression remains incompletely understood.OBJECTIVE: To investigate whether lower retinal nerve fiber layer (RNFL) thickness, a marker of neurodegeneration, is associated with the incidence of clinically relevant depressive symptoms and depressive symptoms over time.DESIGN, SETTING, AND PARTICIPANTS: This is a population-based cohort study from the Netherlands (The Maastricht Study) with baseline examination between 2010 and 2020 and median (IQR) follow-up of 5.0 (3.0-6.0) years. Participants were recruited from the general population. Individuals with type 2 diabetes were oversampled by design. Data analysis was performed from September 2020 to January 2021.EXPOSURES: RNFL, an index of neurodegeneration, assessed with optical coherence tomography.MAIN OUTCOMES AND MEASURES: Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ)-9 (continuous score, 0-27) at baseline and over time via annual assessments. The presence of clinically relevant depressive symptoms was defined as a PHQ-9 score of 10 or higher.RESULTS: We used data from 4934 participants with depressive symptoms over time (mean [SD] age, 59.7 [8.4] years; 2159 women [50.8%]; 870 had type 2 diabetes [20.5%]). Lower RNFL thickness was associated with higher incidence of clinically relevant depressive symptoms (per 1 SD, hazard ratio 1.11; 95% CI, 1.01-1.23) and more depressive symptoms over time (per 1 SD, rate ratio, 1.04; 95% CI, 1.01-1.06), after adjustment for demographic, cardiovascular, and lifestyle factors.CONCLUSIONS AND RELEVANCE: The findings of this study suggest that lower RNFL thickness is associated with higher incidence of clinically relevant depressive symptoms and more depressive symptoms over time. Hence, neurodegeneration may be associated with the early pathobiology of late-life depression.
KW - Adult
KW - Aged
KW - Cohort Studies
KW - Depressive Disorder/epidemiology
KW - Diabetes Mellitus, Type 2/complications
KW - Female
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Nerve Fibers/pathology
KW - Netherlands/epidemiology
KW - Neurodegenerative Diseases/complications
KW - Retina/anatomy & histology
UR - http://www.scopus.com/inward/record.url?scp=85119205539&partnerID=8YFLogxK
U2 - 10.1001/jamanetworkopen.2021.34753
DO - 10.1001/jamanetworkopen.2021.34753
M3 - Article
C2 - 34783825
SN - 2574-3805
VL - 4
JO - JAMA network open
JF - JAMA network open
IS - 11
M1 - e2134753
ER -