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. 2017 Aug 15;7(8):e1208.
doi: 10.1038/tp.2017.155.

Repeated exposure to systemic inflammation and risk of new depressive symptoms among older adults

J A Bell  1 , M Kivimäki  1 , E T Bullmore  2 , A Steptoe  1 ; MRC ImmunoPsychiatry Consortium; L A Carvalho  1   3
Collaborators, Affiliations

Repeated exposure to systemic inflammation and risk of new depressive symptoms among older adults

J A Bell et al. Transl Psychiatry. .

Abstract

Evidence on systemic inflammation as a risk factor for future depression is inconsistent, possibly due to a lack of regard for persistency of exposure. We examined whether being inflamed on multiple occasions increases risk of new depressive symptoms using prospective data from a population-based sample of adults aged 50 years or older (the English Longitudinal Study of Ageing). Participants with less than four of eight depressive symptoms in 2004/05 and 2008/09 based on the Eight-item Centre for Epidemiologic Studies Depression scale were analysed. The number of occasions with C-reactive protein ⩾3 mg l-1 over the same initial assessments (1 vs 0 occasion, and 2 vs 0 occasions) was examined in relation to change in depressive symptoms between 2008/09 and 2012/13 and odds of developing depressive symptomology (having more than or equal to four of eight symptoms) in 2012/13. In multivariable-adjusted regression models (n=2068), participants who were inflamed on 1 vs 0 occasion showed no increase in depressive symptoms nor raised odds of developing depressive symptomology; those inflamed on 2 vs 0 occasions showed a 0.10 (95% confidence intervals (CIs)=-0.07, 0.28) symptom increase and 1.60 (95% CI=1.00, 2.55) times higher odds. In further analyses, 2 vs 0 occasions of inflammation were associated with increased odds of developing depressive symptoms among women (odds ratio (OR)=2.75, 95% CI=1.53, 4.95), but not among men (OR=0.70, 95% CI=0.29, 1.68); P-for-sex interaction=0.035. In this cohort study of older adults, repeated but not transient exposure to systemic inflammation was associated with increased risk of future depressive symptoms among women; this subgroup finding requires confirmation of validity.

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Conflict of interest statement

ETB works half-time for the University of Cambridge and half-time for GlaxoSmithKline; he holds stock in GSK. The remaining authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Outline of the prospective study design for developing depressive symptoms using the English Longitudinal Study of Ageing. BMI, body mass index; CES-D, Centre for Epidemiologic Studies Depression; CRP, C-reactive protein.
Figure 2
Figure 2
Odds of developing individual depressive symptoms after 4 years based on the number of occasions inflamed (n=813). Symptoms refer to experiences in the week preceding assessment. Sample includes 497 participants inflamed on zero occasions, 178 participants inflamed on one occasion and 138 participants inflamed on two occasions.
See this image and copyright information in PMC

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