Serum Levels of Inflammatory Markers in Depressed Elderly Patients with Diabetes and Mild Cognitive Impairment

Abstract

ObjectiveThe aim of the study was to determine the serum levels of CRP, IL-6 and TNF-α in elderly diabetic patients with depressive syndrome alone or with coexisting mild cognitive impairment (MCI).Methods276 diabetics elders were screened for depressive symptoms (using Geriatric Depression Scale: GDS-30) and MCI (using the Montreal Cognitive Assessment: MoCA score). Data of HbA1c, blood lipids and inflammatory markers levels were collected.ResultsIn all groups of patients levels of CRP, IL-6 and TNF-α were significantly higher as compared to controls. The highest level of inflammatory markers was detected in group with depressive mood and coexisting MCI, however IL-6 level didn’t significantly differ as compared to MCI group. We founded correlations between all inflammatory markers in group of patients with depressive mood and in group of subjects with depressive symptoms and coexisting MCI. GDS-30 score was correlated with levels of inflammatory markers in group with depressive mood, and with levels of CRP and TNF-α in group with depressive mood and coexisting MCI. In the group with depressive mood and coexisting MCI we founded that MoCA score was negatively correlated with CRP and TNF-α levels; and HbA1c level was positively correlated with all inflammatory markers. The univariate logistic regression models revealed that variables which increased the likelihood of having been diagnosed with MCI in depressed patients were: higher levels of HbA1c, CRP, IL-6 and TNF-α, previous CVD or stroke, increased number of co-morbidities and microvascular complications, older age, less years of formal education. The multivariable model showed that previous CVD, higher HbA1c and IL-6 levels are significant factors.ConclusionsWe demonstrated that the presence of depressive syndrome is associated with higher levels of inflammatory markers in elderly patients with diabetes. The presence of MCI in these depressed subjects has additive effect on levels of inflammatory mediators.

Cytokine alterations and cognitive impairment in major depressive disorder: From putative mechanisms to novel treatment targets

“…The association between levels of IL-6 and cognitive impairment in MDD has been investigated in the majority of studies addressing the impact of peripheral cytokines on cognition (Dannehl et al, 2014;Duivis et al, 2013;Elderkin-Thompson et al, 2012;Gimeno et al, 2008;Goldsmith et al, 2016a;Gorska-Ciebiada et al, 2015;Grassi-Oliveira et al, 2011;Jehn et al, 2015;Krogh et al, 2014;Matsushima et al, 2015). In these studies higher levels of IL-6 were associated with worse cognitive performance on encoding and recall in depressed and healthy elders (Elderkin-Thompson et al, 2012), psychomotor speed in medication-naïve patients with MDD (Goldsmith et al, 2016a) as well as immediate and delayed verbal recall in patients with MDD (Grassi-Oliveira et al, 2011).…”

“…In these studies higher levels of IL-6 were associated with worse cognitive performance on encoding and recall in depressed and healthy elders (Elderkin-Thompson et al, 2012), psychomotor speed in medication-naïve patients with MDD (Goldsmith et al, 2016a) as well as immediate and delayed verbal recall in patients with MDD (Grassi-Oliveira et al, 2011). In the study of diabetic elders, higher levels of IL-6 predicted higher likelihood of having been diagnosed with mild cognitive impairment (MCI) (Gorska-Ciebiada et al, 2015). Another study on depressed cancer patients revealed that IL-6 levels was negatively correlated with the Brain-Derived Neurotrophic Factor (BDNF) levels (Jehn et al, 2015).…”

“…The impact of peripheral TNF-α levels on cognition was addressed in seven studies (Dannehl et al, 2014;Duivis et al, 2013;Euteneuer et al, 2012;Gorska-Ciebiada et al, 2015;Grassi-Oliveira et al, 2011;Matsushima et al, 2015;Smagula et al, 2016). In one study (Gorska-Ciebiada et al, 2015), higher levels of IL-6 predicted higher likelihood of having been diagnosed with MCI in depressed…”

Neurocognitive Impairment as Systemic Effects of COPD

“…including central nervous system impairment [45,46]. The chronic inlammatory status may contribute to vessel wall changes (endothelial dysfunction, stifening of arteries and arterioles and impaired vascular reactivity) and may also have neurotoxic efects: synaptic dysfunction and neural cell apoptosis [46][47][48][49].…”

Ghrelin Levels in Elderly, Diabetic Patients with Mild Cognitive Impairment

“…Despite the clear link between cognitive impairment and diabetes disorders in epidemiologic studies, relatively little is known about the mechanism that underlies this association. A lot of studies had suggested that cognitive dysfunction in diabetes could be connected with severe hypoglycemia or persistent hyperglycemia, depression, inflammation, an increased prevalence of macrovascular and microvascular disease [6,7]. All these vascular etiology factors can interfere with other neurological changes in the aging brain and worsen the cognition [8].…”