Search

Aim: The current study aims to investigate the association of serum brain‐derived neurotrophic factor (BDNF) levels with symptoms of depression in adults with and without prevalent cardiovascular disease (CVD), an often burdensome comorbidity. Methods: This cross‐sectional study included participants from FHS (Framingham Heart Study) who had available serum BDNF levels. Depressive symptoms were assessed using the Center for Epidemiological Studies–Depression Scale (CES‐D) with a score ≥16 indicating mild to moderate and ≥21 severe depression. Participants taking antidepressant medications were excluded from the study. Results: Altogether 3716 FHS participants were included in the final analysis (mean age, 64.3 ± 11.5 years; 55% women). After adjusting for potential confounders, greater BDNF levels were associated with reduced severe depression risk (odds ratio [OR], 0.78 [95% CI, 0.64–0.96]; P = 0.016). Among participants with CVD, greater BDNF levels were related to lower risk of depressive symptoms (CES‐D ≥ 16 OR, 0.63 [95% CI, 0.45–0.89], P = 0.008; CES‐D ≥ 21 OR, 0.49 [95% CI, 0.31–0.76], P = 0.002). The inverse relationship between BDNF and depressive symptom risk was present in women with CVD (CES‐D ≥ 16 OR, 0.63 [95% CI, 0.40–0.99], P = 0.047; CES‐D ≥ 21 OR, 0.38 [95% CI, 0.21–0.70], P = 0.002) but not in men. Conclusion: Lower serum BDNF levels are associated with a higher risk of depressive symptoms in CVD, particularly among women. These findings implicate BDNF in the complex biological mechanisms that underlie prior associations observed between CVD and depression. To reduce the burden of depression in the large proportion of midlife and older adults with CVD, a better understanding of how BDNF may modify these pathways is merited. [ABSTRACT FROM AUTHOR]

Objective Methods Results Interpretation Subclinical vascular brain injury is an increasingly recognized risk factor for stroke and dementia. Despite well‐established sex differences in vascular risk and disease prevalence, the impact of sex on drivers of subclinical vascular brain injury remains unclear, presenting a barrier to developing sex‐specific prevention guidelines. We aimed to establish the extent to which sex moderates associations between vascular risk factors and magnetic resonance imaging (MRI) measures of subclinical brain injury in stroke‐free older adults.We leveraged cross‐sectional data from 1,579 stroke‐ and dementia‐free Framingham Heart Study Offspring participants at exam 8 (age 65.7 ± 8.8 years, 53% women). Vascular risks were assessed using components of the Framingham Stroke Risk Profile (FSRP) and diastolic blood pressure (DBP). White matter hyperintensity volume (WMH), total cerebral brain volume (TBV), and covert brain infarcts were quantified using MRI. We examined whether vascular risk factors were associated with MRI measures across the combined cohort, and then determined whether sex modified these associations.Higher FSRP and specifically systolic blood pressure (SBP) were associated with greater WMH. These associations were stronger in women and remained after adjusting for menopause age and hormone therapy use. By contrast, diabetes and lower DBP were associated with smaller TBV primarily in men. The DBP‐atrophy relationship was only observed in men with declining DBP or prior hypertension.Our findings highlight differential vulnerability to the impact of vascular risk factors on white matter health in women and global atrophy in men, supporting the development of sex‐specific guidelines to better preserve vascular brain health in aging. ANN NEUROL 2024 [ABSTRACT FROM AUTHOR]