Objective: The aim of the study was to explore the vascular depression hypothesis in a large cohort of multiple system atrophy (MSA).

Background: Previous studies have proposed a hypothesis about the vascular depression in late life. However, the association between vascular risk factors and depression are inconsistent.

Method: A total of 575 consecutive patients with a probable diagnosis of MSA were included. The clinical data of age, sex, height, weight, disease duration, history of hypertension, diabetes mellitus, hyperlipidemia, smoking, and drinking were collected. Patients were divided into absence of depression (score ≤ 20) and presence of depression (score > 20) according to assessment of the Hamilton Depression Rating Scale. The binary logistic regression was used to analyze the association between vascular risk factors and depression.

Results: The mean age of MSA patients with 273 females and 302 males was 60.03±8.65 years old. Mean age of onset was 57.35±8.64 years. Mean disease duration was 2.64±1.54 years. There were 18.3% patients with hypertension, 9.0% with diabetes mellitus, 13.7% with hyperlipidemia, 7.7% with current smoking, 30.8% with former smoking, 6.4% with current drinking, 25.9% with former drinking, 35.1% with overweight, and 8.5% with obesity. In the binary logistic regression model, hypertension was associated with depression in MSA-C patients (OR 2.64, 95% CI 1.12-6.23, P=0.026) after adjusted for age, sex, and disease duration. There were no association between vascular risk factors and depression in MSA-P patients.

Conclusion: we first established the vascular depression hypothesis in MSA. Hypertension was associated with depression in MSA-C patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/vascular-risk-factors-and-depression-in-multiple-system-atrophy/