Asymptomatic spontaneous cerebral emboli and mood in a cohort of older people: A prospective study

OBJECTIVE: To examine whether asymptomatic spontaneous cerebral emboli (SCE) predicts subsequent depression in older people. METHODS: Prospective cohort study with 2.5 years of follow-up including 96 nondepressed older subjects in primary care. Presence of SCE was measured at baseline by transcranial Doppler of the middle cerebral artery and modeled on depression at follow-up using multiple logistic and linear regression analyses. RESULTS: The prevalence of depressive disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria did not differ significantly between SCE-positive and SCE-negative subjects (27% versus 12%), while the severity of depressive symptoms did (Geriatric Depression Scale: 2 = 0.22; Montgomery-Asberg Depression Rating Scale: 2 = 0.25). These differences disappeared after adjustment for cardiovascular risk factors. CONCLUSION: These preliminary findings suggest that asymptomatic SCE may be an interceding factor in the development of late-life depression, consistent with the vascular depression hypothesis.