Cardiometabolic dysregulation and cognitive decline: potential role of depressive symptoms

Br J Psychiatry. 2018 Feb;212(2):96-102. doi: 10.1192/bjp.2017.26.


Background: Previous studies have examined associations of cardiometabolic factors with depression and cognition separately. Aims To determine if depressive symptoms mediate the association between cardiometabolic factors and cognitive decline in two community studies.

Method: Data for the analyses were drawn from the Rotterdam Study, the Netherlands (n = 2940) and the Whitehall II study, UK (n = 4469).

Results: Mediation analyses suggested a direct association between cardiometabolic factors and cognitive decline and an indirect association through depression: poorer cardiometabolic status at time 1 was associated with a higher level of depressive symptoms at time 2 (standardised regression coefficient 0.07 and 0.06, respectively), which, in turn, was associated with greater cognitive decline between time 2 and time 3 (standardised regression coefficient of -0.15 and -0.41, respectively).

Conclusions: Evidence from two independent cohort studies suggest an association between cardiometabolic dysregulation and cognitive decline and that depressive symptoms tend to precede this decline. Declaration of interest None.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cognitive Dysfunction / epidemiology*
  • Cohort Studies
  • Comorbidity
  • Depression / epidemiology*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Humans
  • Hypertension / epidemiology*
  • Inflammation / blood
  • Inflammation / epidemiology*
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Netherlands / epidemiology
  • Obesity / epidemiology*
  • United Kingdom / epidemiology