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: β = 0.22; Montgomery-Asberg Depression Rating Scale: β = 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.