The British Journal of Psychiatry (2006) 189: 260-263. doi: 10.1192/bjp.bp.105.016188
© 2006 The Royal College of Psychiatrists
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Cerebral emboli and depressive symptoms in dementia

Nitin Purandare, MRCPsych

University of Manchester, Division of Psychiatry, Education and Research Centre, South Manchester University Hospital, Manchester, UK

Richard C. Oude Voshaar, MD, PhD

University of Manchester, Division of Psychiatry, Education and Research Centre, South Manchester University Hospital, Manchester, UK and Department of Psychiatry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Jayne Hardicre, MSc

Vascular Studies Unit, Academic Surgery Unit, University of Manchester

Jane Byrne, MRCPsych

University of Manchester, Division of Psychiatry, Education and Research Centre, South Manchester University Hospital, Manchester

Charles McCollum, MD, FRCS

Vascular Studies Unit, Academic Surgery Unit, University of Manchester

Alistair Burns, FRCPsych

University of Manchester, Division of Psychiatry, Education and Research Centre, South Manchester University Hospital, Manchester, UK

Correspondence: Dr N. Purandare, University of Manchester, Division of Psychiatry, Education and Research Centre, 2nd floor, Wythenshawe Hospital, Manchester M23 9LT, UK. Tel: +44 (0)161 291 5887; fax: +44 (0)161 291 5882; email: nitin.purandare{at}manchester.ac.uk

Declaration of interest None.

Funding detailed in Acknowledgements.

Background The vascular depression hypothesis and our recent findings of increased frequency of spontaneous cerebral emboli in dementia suggest that such emboli may be involved in the causation of depressive symptoms in dementia.

Aims To evaluate the association between spontaneous cerebral emboli and depressive symptoms in Alzheimer's disease and vascular dementia.

Method In a cohort of 142 patients with dementia (72 with Alzheimer's disease and 70 with vascular dementia), the association between spontaneous cerebral emboli and clinically relevant depressive symptoms was examined using multiple logistic regression analyses.

Results Spontaneous cerebral emboli were significantly more frequent in the patients with clinically relevant depressive symptoms (66 v. 37%, P=0.03). After adjustment for age, gender, Mini-Mental State Examination score, type of dementia and significant cardiovascular risk factors, the relationship remained significant (OR=3.47, 95% CI 1.10-10.97).

Conclusions Spontaneous cerebral emboli are associated with clinically relevant depressive symptoms in dementia, and further research is needed to explore the nature of this relationship.


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