Publication Abstract Display
Type: Published Abstract
Title: Independent association between depressed mood severity and stress procoagulant activity and recovery in the elderly.
Authors: , Dimsdale JE, Adler KA, Patterson TL, Grant I
Year: 2003
Publication: Psychosomatic Medicine
Volume: 65 Issue: 1 Pages: A65
Abstract:Depressed mood severity is prospectively associated with cardiovascular morbidity and mortality. Increased clotting diathesis may be one candidate mechanism mediating this empirical observation. Given the sympathetic nervous system is hyperactive in depression, we hypothesized that there would be an association between depressed mood and fibrin turnover with acute mental stress. Study participants were 55 (37 women, 18 men) community-dwelling elderly subjects (mean age±SD, 71±8 years) who had depressed mood symptoms assessed with the interviewer administrated 17-item Hamilton Rating Scale for Depression (Ham-D). The mental stressor comprised instruction, preparation and delivering of a 3-min speech about an upsetting event. Blood samples were drawn at rest, immediately after conclusion of the speech and 14 min afterward (recovery). Plasma D-dimer levels, reflecting fibrin turnover, were measured by an enzyme-linked immunosorbent assay. Mean±SD Ham-D score was 4.0±3.6 (range 0-13), with women feeling more depressed than men (4.6±3.8 vs. 2.6±2.8; p=.021). D-dimer significantly increased (p<.001) from rest (596±527ng/ml) to stress (1357±1091ng/ml) and to recovery (1615±1373ng/ml). Ham-D scores (R2=.21, p<.001), resting heart rate (R2 change=.12; p=.003), and gender (R2 change=.05; p=.044) together explained 38% of the variance in D-dimer area under the curve (rest, stress, recovery). Age, medication, cardiovascular disease status and risk factors known to affect D-dimer levels did not enter the regression equation. The finding suggests an independent association of stress-induced fibrin formation and delayed recovery with depressed mood in elderly subjects, in line with previous findings on platelet hyperactivity in depression. Such a mechanism adds to the emerging biobehavioral pathways linking depression with cardiovascular disease.

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