Depression and Cognitive Dysfunction in Older U.S. Military Veterans: Moderating Effects of BDNF Val66Met Polymorphism and Physical Exercise

Am J Geriatr Psychiatry. 2020 Sep;28(9):959-967. doi: 10.1016/j.jagp.2020.02.001. Epub 2020 Feb 7.

Abstract

Objective: Depression is associated with increased risk for cognitive dysfunction, yet little is known about genetic and behavioral factors that may moderate this association. Using data from a nationally representative sample of older U.S. military veterans, we examined the direct and interactive effects of depression, brain-derived neurotropic factor (BDNF) Val66Met genotype, and physical exercise on cognitive functioning.

Methods: One thousand three hundred eighty-six older European-American U.S. military veterans (mean age = 63) completed a web-based survey and cognitive assessment. Analyses of covariance were conducted to evaluate the effects of depression, BDNF Met allele carrier status, and physical exercise on these measures.

Results: Depressed veterans scored worse than nondepressed veterans on subjective measures of cognitive functioning (Cohen d's = 0.34-0.57) and objective measures of visual learning (d = 0.39) and working memory (d = 0.28). Among depressed veterans, those who were Met allele carriers scored worse than Val/Val homozygotes on subjective cognitive measures (d's = 0.52-0.97) and an objective measure of visual learning (d = 0.36). Engagement in physical exercise moderated the association between depression and cognitive function, with depressed exercisers scoring better than depressed nonexercisers on a subjective measure of reasoning, and objective measures of processing speed, attention, and visual learning (d = 0.58-0.99): further, in depressed Met allele carriers, exercisers scored better than nonexercisers on subjective cognitive (d's = 0.80-1.92), and objective measures of visual learning (d = 0.8-1.31) and working memory (d = 0.67).

Conclusion: Depression is associated with moderate decrements in cognitive functioning in older U.S. military veterans, and this association is moderated by BDNF Val66Met genotype and physical exercise. Prevention and treatment efforts designed to promote physical exercise may help preserve cognitive functioning in at-risk veterans.

Keywords: Brain-derived neurotrophic factor; cognitive function; depression; exercise; veterans.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Brain-Derived Neurotrophic Factor / genetics*
  • Cognition / physiology*
  • Cognitive Dysfunction* / diagnosis
  • Cognitive Dysfunction* / etiology
  • Cognitive Dysfunction* / psychology
  • Depression* / diagnosis
  • Depression* / genetics
  • Depression* / psychology
  • Europe / epidemiology
  • Exercise* / physiology
  • Exercise* / psychology
  • Female
  • Humans
  • Male
  • Military Personnel
  • Neuropsychological Tests
  • Outcome Assessment, Health Care
  • Polymorphism, Single Nucleotide
  • Surveys and Questionnaires
  • United States / epidemiology
  • Veterans / psychology*

Substances

  • Brain-Derived Neurotrophic Factor
  • BDNF protein, human