Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb;52(3):515-525.
doi: 10.1017/S0033291720002159. Epub 2020 Jul 3.

Subtyping late-life depression according to inflammatory and metabolic dysregulation: a prospective study

K J E Kokkeler  1   2 , R M Marijnissen  2 , K J Wardenaar  2 , D Rhebergen  3 , R H S van den Brink  2 , R C van der Mast  4   5 , R C Oude Voshaar  2
Affiliations

Subtyping late-life depression according to inflammatory and metabolic dysregulation: a prospective study

K J E Kokkeler et al. Psychol Med. 2022 Feb.

Abstract

Background: Inflammation and metabolic dysregulation are age-related physiological changes and are associated with depressive disorder. We tried to identify subgroups of depressed older patients based on their metabolic-inflammatory profile and examined the course of depression for these subgroups.

Methods: This clinical cohort study was conducted in a sample of 364 depressed older (⩾60 years) patients according to DSM-IV criteria. Severity of depressive symptoms was monitored every 6 months and a formal diagnostic interview repeated at 2-year follow-up. Latent class analyses based on baseline metabolic and inflammatory biomarkers were performed. Adjusted for confounders, we compared remission of depression at 2-year follow-up between the metabolic-inflammatory subgroups with logistic regression and the course of depression severity over 2-years by linear mixed models.

Results: We identified a 'healthy' subgroup (n = 181, 49.7%) and five subgroups characterized by different profiles of metabolic-inflammatory dysregulation. Compared to the healthy subgroup, patients in the subgroup with mild 'metabolic and inflammatory dysregulation' (n = 137, 37.6%) had higher depressive symptom scores, a lower rate of improvement in the first year, and were less likely to be remitted after 2-years [OR 0.49 (95% CI 0.26-0.91)]. The four smaller subgroups characterized by a more specific immune-inflammatory dysregulation profile did not differ from the two main subgroups regarding the course of depression.

Conclusions: Nearly half of the patients with late-life depressions suffer from metabolic-inflammatory dysregulation, which is also associated with more severe depression and a worse prognosis. Future studies should examine whether these depressed older patients benefit from a metabolic-inflammatory targeted treatment.

Keywords: Aged; depression; inflammation; latent class analysis; metabolic syndrome.

PubMed Disclaimer

Conflict of interest statement

The authors have no financial of any other kind of personal conflicts with this paper.

Figures

Fig. 1.
Fig. 1.
Estimated course of depression severity over the first year (adjusted for age, sex, years of education, smoking, alcohol use, physical activity, somatic comorbidity, global cognitive functioning and use of antidepressants). Class A: ‘Healthy’, class B: ‘Metabolic and inflammatory dysregulation’, class C: ‘Severe inflammation’, class D: ‘Mild inflammation’.
See this image and copyright information in PMC

References

    1. Aalto, M., Alho, H., Halme, J. T., & Seppä, K. (2011). The Alcohol Use Disorders Identification Test (AUDIT) and its derivatives in screening for heavy drinking among the elderly. International Journal of Geriatric Psychiatry, 26(9), 881–885. - PubMed
    1. Au, B., Smith, K. J., Gariépy, G., & Schmitz, N. (2015). The longitudinal associations between C-reactive protein and depressive symptoms: Evidence from the English Longitudinal Study of Ageing (ELSA). International Journal of Geriatric Psychiatry, 30(9), 976–984. - PubMed
    1. Babor, T. F., Kranzler, H. R., & Lauerman, R. J. (1989). Early detection of harmful alcohol consumption: Comparison of clinical, laboratory, and self-report screening procedures. Addictive Behaviors, 14(2), 139–157. - PubMed
    1. Beijers, L., Wardenaar, K. J., Bosker, F. J., Lamers, F., van Grootheest, G., de Boer, M. K., … Schoevers, R. A. (2018). Biomarker-based subtyping of depression and anxiety disorders using latent class analysis. A NESDA study. Psychological Medicine, 49(4), 617–627. - PMC - PubMed
    1. Capuron, L., Su, S., Miller, A. H., Bremner, J. D., Goldberg, J., Vogt, G. J., … Vaccarino, V. (2008). Depressive symptoms and metabolic syndrome: Is inflammation the underlying link? Biological Psychiatry, 64(10), 896–900. - PMC - PubMed

Publication types