1. Sound waves boost older adults’ memory, deep sleep

    March 23, 2017 by Ashley

    From the Northwestern University press release:

    IF

    Gentle sound stimulation — such as the rush of a waterfall — synchronized to the rhythm of brain waves significantly enhanced deep sleep in older adults and improved their ability to recall words, reports a new Northwestern Medicine study.

    Deep sleep is critical for memory consolidation. But beginning in middle age, deep sleep decreases substantially, which scientists believe contributes to memory loss in aging.

    The sound stimulation significantly enhanced deep sleep in participants and their scores on a memory test.

    “This is an innovative, simple and safe non-medication approach that may help improve brain health,” said senior author Dr. Phyllis Zee, professor of neurology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine sleep specialist. “This is a potential tool for enhancing memory in older populations and attenuating normal age-related memory decline.”

    The study will be published March 8 in Frontiers in Human Neuroscience.

    In the study, 13 participants 60 and older received one night of acoustic stimulation and one night of sham stimulation. The sham stimulation procedure was identical to the acoustic one, but participants did not hear any noise during sleep. For both the sham and acoustic stimulation sessions, the individuals took a memory test at night and again the next morning. Recall ability after the sham stimulation generally improved on the morning test by a few percent. However, the average improvement was three times larger after pink-noise stimulation.

    The older adults were recruited from the Cognitive Neurology and Alzheimer’s Disease Center at Northwestern.

    The degree of slow wave sleep enhancement was related to the degree of memory improvement, suggesting slow wave sleep remains important for memory, even in old age.

    Although the Northwestern scientists have not yet studied the effect of repeated nights of stimulation, this method could be a viable intervention for longer-term use in the home, Zee said.

    Previous research showed acoustic simulation played during deep sleep could improve memory consolidation in young people. But it has not been tested in older adults.

    The new study targeted older individuals — who have much more to gain memory-wise from enhanced deep sleep — and used a novel sound system that increased the effectiveness of the sound stimulation in older populations.

    The study used a new approach, which reads an individual’s brain waves in real time and locks in the gentle sound stimulation during a precise moment of neuron communication during deep sleep, which varies for each person.

    During deep sleep, each brain wave or oscillation slows to about one per second compared to 10 oscillations per second during wakefulness.

    Giovanni Santostasi, a study coauthor, developed an algorithm that delivers the sound during the rising portion of slow wave oscillations. This stimulation enhances synchronization of the neurons’ activity.

    After the sound stimulation, the older participants’ slow waves increased during sleep.

    Larger studies are needed to confirm the efficacy of this method and then “the idea is to be able to offer this for people to use at home,” said first author Nelly Papalambros, a Ph.D. student in neuroscience working in Zee’s lab. “We want to move this to long-term, at-home studies.”

    Northwestern scientists, under the direction of Dr. Roneil Malkani, assistant professor of neurology at Feinberg and a Northwestern Medicine sleep specialist, are currently testing the acoustic stimulation in overnight sleep studies in patients with memory complaints. The goal is to determine whether acoustic stimulation can enhance memory in adults with mild cognitive impairment.

    Previous studies conducted in individuals with mild cognitive impairment in collaboration with Ken Paller, professor of psychology at the Weinberg College of Arts and Sciences at Northwestern, have demonstrated a possible link between their sleep and their memory impairments.


  2. Blueberry concentrate improves brain function in older people

    March 20, 2017 by Ashley

    From the University of Exeter press release:

    Blueberries

    Drinking concentrated blueberry juice improves brain function in older people, according to research by the University of Exeter.

    In the study, healthy people aged 65-77 who drank concentrated blueberry juice every day showed improvements in cognitive function, blood flow to the brain and activation of the brain while carrying out cognitive tests.

    There was also evidence suggesting improvement in working memory.

    Blueberries are rich in flavonoids, which possess antioxidant and anti-inflammatory properties.

    Dr Joanna Bowtell, head of Sport and Health Sciences at the University of Exeter, said: “Our cognitive function tends to decline as we get older, but previous research has shown that cognitive function is better preserved in healthy older adults with a diet rich in plant-based foods.

    “In this study we have shown that with just 12 weeks of consuming 30ml of concentrated blueberry juice every day, brain blood flow, brain activation and some aspects of working memory were improved in this group of healthy older adults.”

    Of the 26 healthy adults in the study, 12 were given concentrated blueberry juice — providing the equivalent of 230g of blueberries — once a day, while 14 received a placebo.

    Before and after the 12-week period, participants took a range of cognitive tests while an MRI scanner monitored their brain function and resting brain blood flow was measured.

    Compared to the placebo group, those who took the blueberry supplement showed significant increases in brain activity in brain areas related to the tests.

    The study excluded anyone who said they consumed more than five portions of fruit and vegetables per day, and all participants were told to stick to their normal diet throughout.

    Previous research has shown that risk of dementia is reduced by higher fruit and vegetable intake, and cognitive function is better preserved in healthy older adults with a diet rich in plant-based foods.

    Flavonoids, which are abundant in plants, are likely to be an important component in causing these effects.


  3. Might smartphones help to maintain memory in patients with mild Alzheimer’s disease?

    by Ashley

    From the IOS Press press release:

    The patient is a retired teacher who had reported memory difficulties 12 months prior to the study. These difficulties referred to trouble remembering names and groceries she wanted to purchase, as well as frequently losing her papers and keys. According to the patient and her husband, the main difficulties that she encountered were related to prospective memory (e.g., forgetting medical appointments or to take her medication).

    To help her with her symptoms, Mohamad El Haj, a psychologist and assistant professor at the University of Lille, proposed Google Calendar, a time-management and scheduling calendar service developed by Google. The patient accepted as she was already comfortable using her smartphone. She also declared that she preferred the application as it offers more discrete assistance than a paper-based calendar.

    With the patient and her husband, Dr. El Haj and his colleagues defined several prospective omissions in the patient, such as forgetting her weekly medical appointment, forgetting her weekly bridge game in the community club, and forgetting to go to weekly mass at the church. These omissions were targeted by sending automatic alerts, prompted by Google Calendar, at different times before each event (e.g., the medical appointment).

    The researchers compared omissions before after the use of Google Calendar, they observed less omission after implementing the application.

    The study is the first to suggest positive effects of smartphones applications on everyday life prospective memory in Alzheimer’s disease. The findings, published in Journal of Alzheimer’s disease, are encouraging, however, Dr. El Haj notes that this is a case study and therefore entails a few limitations, including generalizability of the results. The current, anecdotal findings require a larger study, not only to confirm or refute the findings reported here, but also to address challenges such as the long-term benefits of Google calendar.

    Regardless of its potential limitations, Dr. El Haj notes that this study addresses memory loss, the main cognitive hallmark of Alzheimer’s disease and the major concern of the patients and their families. By demonstrating positive effect of Google Calendar on prospective memory in this patient, Dr. El Haj hopes that his study paves the way for exploring the potential of smartphone-integrated memory aids in Alzheimer’s disease. The future generation of patients may be particularly sensitive to the use of smartphones as a tool to alleviate their memory compromise.


  4. Mild cognitive impairment (MCI) detected with brain training game

    March 17, 2017 by Ashley

    From the IOS Press press release:

    Greek researchers demonstrated the potential of a self-administered virtual supermarket cognitive training game for remotely detecting mild cognitive impairment (MCI), without the need for an examiner, among a sample of older adults. MCI patients suffer from cognitive problems and often encounter difficulties in performing complex activities such as financial planning. They are at a high risk for progressing to dementia however early detection of MCI and suitable interventions can stabilize the patients’ condition and prevent further decline.

    It has been shown that virtual reality game-based applications and especially virtual supermarkets can detect MCI. Past studies have utilized user performance in such applications along with data from standardized neuropsychological tests in order to detect MCI. The team that conducted this study was the first scientific team to achieve reliable MCI detection using a virtual reality game-based application on its own. In that previous study , administration of the virtual super market (VSM) exercise was conducted by an examiner. The present study eliminated the need for an examiner by calculating the average performance of older adults using a special version of the VSM application, the VSM Remote Assessment Routine (VSM-RAR), at home on their own, for a period of one month. It is the first instance where a self-administered virtual reality application was used to detect MCI with a high degree of reliability.

    The research team included scientists from the Aristotle University of Thessaloniki (AUTH), the Centre for Research and Technology Hellas/Information Technologies Institute (CERTH/ITI), the Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD) and the Network Aging Research (NAR) of the University of Heidelberg.

    In an article published in the Journal of Alzheimer’s Disease, the researchers have indicated that the virtual supermarket remote assessment routine (VSM-RAR) application displayed a correct classification rate (CCR) of 91.8% improving VSM’s CCR as assessed in the previous VSM study while achieving a level of diagnostic accuracy similar to the most accurate standardized neuropsychological tests, which are considered the gold standard for MCI detection.

    Self-administered computerized cognitive training exercises/games are gaining popularity among older adults as an easy and enjoyable means of maintaining cognitive health. Such applications are especially popular among older adults who consider themselves healthy and are not inclined to visit specialized memory clinics for cognitive assessment. If self-administered games and exercises could also detect cognitive disorders, initial cognitive screening could be conducted remotely. The wide implementation of this method of remote screening would facilitate the detection of cognitive impairment at the MCI stage thus allowing for more efficient therapeutic interventions.

    This preliminary study indicates that automated, remote MCI screening is feasible. This method could be utilized to screen the majority of the older adult population, as it dramatically lowers examination-related costs. The social and economic benefits, especially caregiver and healthcare service burden, of the early detection of cognitive disorders could be enormous. At the same time, as older adults are becoming increasingly computer savvy, it is important to create software that meets their needs and allows them to remain healthy and active. Out team continues its research on the VSM with the aim of improving its usability, shortening its administration time and supplementing the science behind VSM with additional data.


  5. Study suggests website design can reduce risk of “incompatible purchases”

    March 14, 2017 by Ashley

    From the European Commission, Joint Research Centre (JRC) media release:

    Small changes in the website design of online shops could significantly reduce the risk of incompatible purchases by customers, concludes a recent JRC study published on 10 March in PLOS ONE. Warning messages appealing to the customer’s emotions and information provided at check-out were the most effective methods of avoiding disappointment.

    Have you ever bought a video game or a DVD online and only noticed when trying to use it, that it is not compatible with your device? While the digital market is growing and the choice for e-commerce platforms and sellers is expanding, consumer policies have to ensure that the rules and regulations that apply to online shopping are up-to-date and effectively protect all customers.

    Laboratory experiment to test effectiveness of nudges

    The JRC conducted a laboratory experiment with 626 participants to test whether web design could reduce the number of incompatible purchases online. During the experiment, the participants of different age, gender and educational backgrounds had virtual currency to purchase digital products on an e-commerce website, and then test their purchases.

    The purpose of this experiment was to see how the participants reacted to the different kind of nudges, i.e. warning messages and compatibility information provided by the e-commerce website regarding the products they were purchasing.

    Emotive warnings and information at checkout most effective

    Messages appealing to the customer’s emotions, such as ‘To avoid disappointment, please ensure that the product you are buying is compatible with your device,” combined with an emoticon (a sad face) were the most effective in preventing a participant from purchasing an incompatible product. Surprisingly, a traditional warning message, such as “Please ensure that the product you are buying is compatible with your device” was as effective as no warning message at all.

    The study also concluded that compatibility information provided at the moment of the check-out was more effective than the same information provided on the product description page, and that logos were more effective than text.

    Elderly people more likely to purchase incompatible products online

    Although older consumers have greater shopping experience and a smarter and more sophisticated choice process when it comes to traditional shopping, the study confirmed that they are disadvantaged in online shopping environments. Because of difficulties linked to processing information and using the Internet effectively, as well as lack of social networks online which would help them to navigate the electronic market place, they are more likely to buy incompatible products.

    The study also concluded that the level of education had no impact on the final results.

    Safe online shopping at heart of EU consumer policy

    Ensuring safe and satisfactory online shopping experience for all customers is part of the EU policy objectives linked to consumer protection and the Digital Single Market. The Consumer Rights Directive (2011/83/EU) contains specific provisions on online shopping which require that consumers are informed about the main characteristics, functionality and interoperability of the products they are purchasing. However, even when the information is available, it might be hidden or consumers might not be able to understand or interpret it, which leads to mistakes, disappointment, frustration and ultimately lack of trust in online shopping.

    The results of this study indicate that the right kind of nudges would be an effective solution for encouraging safe and satisfactory online shopping. With small changes to the website design, e-commerce platform owners could avoid disappointed customers and increase the usability of their website.

    The study aims to feed into policies and regulations at EU level to protect consumers, in particular vulnerable consumer groups.


  6. Rapid blood pressure drops in middle age linked to dementia in old age

    by Ashley

    From the Johns Hopkins University Bloomberg School of Public Health media release:

    Middle-aged people who experience temporary blood pressure drops that often cause dizziness upon standing up may be at an increased risk of developing cognitive decline and dementia 20 years later, new Johns Hopkins Bloomberg School of Public Health research suggests.

    The findings, being presented March 10 at the American Heart Association’s EPI|LIFESTYLE 2017 Scientific Sessions in Portland, Ore., suggest that these temporary episodes — known as orthostatic hypotension — may cause lasting damage, possibly because they reduce needed blood flow to the brain. Previous research has suggested a connection between orthostatic hypotension and cognitive decline in older people, but this appears to be the first to look at long-term associations.

    “Even though these episodes are fleeting, they may have impacts that are long lasting,” says study leader Andreea Rawlings, PhD, MS, a post-doctoral researcher in the Department of Epidemiology at the Bloomberg School. “We found that those people who suffered from orthostatic hypotension in middle age were 40 percent more likely to develop dementia than those who did not. It’s a significant finding and we need to better understand just what is happening.”

    An estimated four million to five million Americans currently have dementia and, as the population ages, that number is only expected to grow. There currently is no treatment and no cure for the condition.

    For the study, the researchers analyzed data from the Atherosclerosis Risk in Communities (ARIC) cohort, a study of 15,792 residents in four communities in the United States, who were between the ages of 45 and 64 when the study began in 1987. For this study, they focused on the 11,503 participants at visit one who had no history of coronary heart disease or stroke. After 20 minutes lying down, researchers took the participants’ blood pressure upon standing. Orthostatic hypotension was defined as a drop of 20 mmHg or more in systolic blood pressure or 10 mmHg or more in diastolic blood pressure. Roughly six percent of participants, or 703 people, met the definition.

    These participants, who were on average 54 years old upon enrolling in the study, continued to be followed over the next 20 or more years. People with orthostatic hypotension at the first visit were 40 percent more likely to develop dementia than those who did not have it. They had 15 percent more cognitive decline.

    Rawlings says it is not possible to tease out for certain whether the orthostatic hypotension was an indicator of some other underlying disease or whether the drop in blood pressure itself is the cause, though it is likely that the reduction in blood flow to the brain, however temporary, could have lasting consequences.

    It also wasn’t clear, she says, whether these participants had repeated problems with orthostatic hypotension over many years or whether they had just a brief episode of orthostatic hypotension at the original enrollment visit, as patients were not retested over time.

    “Identifying risk factors for cognitive decline and dementia is important for understanding disease progression, and being able to identify those most at risk gives us possible strategies for prevention and intervention,” Rawlings says. “This is one of those factors worth more investigation.”


  7. Married people have lower levels of stress hormone

    February 15, 2017 by Ashley

    From the Carnegie Mellon University media release:

    couple on dateStudies have suggested that married people are healthier than those who are single, divorced, or widowed. A new Carnegie Mellon University study provides the first biological evidence to explain how marriage impacts health.

    Published in Psychoneuroendocrinology, the researchers found that married individuals had lower levels of the stress hormone cortisol than those who never married or were previously married. These findings support the belief that unmarried people face more psychological stress than married individuals. Prolonged stress is associated with increased levels of cortisol which can interfere with the body’s ability to regulate inflammation, which in turn promotes the development and progression of many diseases.

    “It’s is exciting to discover a physiological pathway that may explain how relationships influence health and disease,” said Brian Chin, a Ph.D. student in the Dietrich College of Humanities and Social Sciences’ Department of Psychology.

    Over three non-consecutive days, the researchers collected saliva samples from 572 healthy adults aged 21-55. Multiple samples were taken during each 24-hour period and tested for cortisol.

    The results showed that the married participants had lower cortisol levels than the never married or previously married people across the three day period. The researchers also compared each person’s daily cortisol rhythm — typically, cortisol levels peak when a person wakes up and decline during the day. Those who were married showed a faster decline, a pattern that has been associated with less heart disease, and longer survival among cancer patients.

    These data provide important insight into the way in which our intimate social relationships can get under the skin to influence our health,” said laboratory director and co-author Sheldon Cohen, the Robert E. Doherty University Professor of Psychology.


  8. Benzodiazepines, related drugs increase stroke risk among persons with Alzheimer’s disease

    January 25, 2017 by Ashley

    From the University of Eastern Finland media release:

    memory lossThe use of benzodiazepines and benzodiazepine-like drugs was associated with a 20 per cent increased risk of stroke among persons with Alzheimer’s disease, shows a recent study from the University of Eastern Finland. Benzodiazepines were associated with a similar risk of stroke as benzodiazepine-like drugs.

    The use of benzodiazepines and benzodiazepine-like drugs was associated with an increased risk of any stroke and ischemic stroke, whereas the association with hemorrhagic stroke was not significant. However, due to the small number of hemorrhagic stroke events in the study population, the possibility of such an association cannot be excluded. The findings are important, as benzodiazepines and benzodiazepine-like drugs were not previously known to predispose to strokes or other cerebrovascular events. Cardiovascular risk factors were taken into account in the analysis and they did not explain the association.

    The findings encourage a careful consideration of the use of benzodiazepines and benzodiazepine-like drugs among persons with Alzheimer’s disease, as stroke is one of the leading causes of death in this population group. Earlier, the researchers have also shown that these drugs are associated with an increased risk of hip fracture.

    The study was based on data from a nationwide register-based study (MEDALZ) conducted at the University of Eastern Finland in 2005-2011. The study population included 45,050 persons diagnosed with Alzheimer’s disease, and 22 per cent of them started using benzodiazepines or benzodiazepine-like drugs.

    The findings were published in International Clinical Psychopharmacology.


  9. The lasting effects of ministrokes may contribute to dementia

    January 24, 2017 by Ashley

    From the Medical University of South Carolina media release:

    hospital emergency signEvidence overwhelmingly supports a link between cognitive decline and cerebrovascular diseases such as atherosclerosis, arteriolosclerosis, and cerebral amyloid angiopathy.

    Not only do individuals with cerebrovascular diseases have a much higher incidence of cortical microinfarcts (mini-strokes), but post-mortem histological and in vivo radiological studies also find that the burden of microinfarcts is significantly greater among people with vascular cognitive impairment and dementia (VCID) than in age-matched, non-demented individuals.

    Until now, the mechanisms by which these miniscule lesions (~0.05 to 3 millimeters in diameter) contribute to cognitive deficits including dementia have been poorly understood.

    Findings from a recent study by investigators at the Medical University of South Carolina (MUSC) provide crucial information for better understanding the impact of microinfarcts, showing that the functional deficits caused by a single microinfarct can affect a larger area of brain tissue and last longer than was previously thought to be the case.

    The functional effects of microinfarcts are extremely difficult to study. Not only are most microinfarcts difficult to detect with standard neuroimaging techniques, mismatches between in vivo functional data and post-mortem histological evidence make it nearly impossible to connect microinfarcts to the timeline of cognitive decline.

    These infarcts are so small and unpredictable, we just haven’t had good tools to detect them while the person was still alive,” said Andy Shih, Ph.D., Assistant Professor of Neurosciences and senior author on the article. “So, until now, we basically just had post-mortem snapshots of these infarcts at the end of the dementia battle as well as measures of the person’s cognitive decline, which might have been taken years before the brain became available for study.”

    Intrigued by the mounting evidence linking cognitive decline and microinfarct burden, Shih’s group hypothesized that microinfarcts might disrupt brain function beyond what was visible by histology or magnetic resonance imaging (MRI).

    Even though a person may experience hundreds of thousands of microinfarcts in their lifetime, each event is extremely small and thought to resolve in a matter of days,” said Shih. “It’s been estimated that, overall, microinfarcts affect less than 2% of the entire human brain. But those estimates of tissue loss are based only on the ‘core’ of the microinfarct, the area of dead or dying tissue that we can see in routine, post-mortem, histological stains.”

    To investigate their theory of broader impacts, the team developed a mouse model so that they could examine the effects of individual cortical microinfarcts on surrounding tissue function in vivo over several weeks post-event. “We needed a preclinical model to create very predictable lesions that we could follow over time,” said Shih. “Also, we needed to be able to obtain readouts of brain activity that were consistent over time.”

    The team used photothrombosis to occlude a single arteriole in the barrel cortex of mice fitted with cranial windows. They then compared functional readouts of sensory-evoked brain activity, indicated by activity-dependent c-Fos expression or in vivo two-photon imaging of single vessel hemodynamic responses, to the location of the microinfarct core.

    Post-mortem, c-Fos immunostaining revealed that an area estimated to be at least 12-times greater in volume than the microinfarct core had been affected by the event. Furthermore, in vivo, two-photon imaging of single vessel, sensory-evoked hemodynamics found that neuronal activity across the affected tissue area remained partially depressed for 14 to 17 days after the microinfarct.

    Together, these data indicate that functional deficits caused by a single microinfarct occur across a much larger area of viable peri-lesional tissue than was previously understood and that the resulting deficits are much longer-lasting.

    I knew larger strokes could have distant effects, but I was surprised that something of this scale could have such a large effect,” said Shih.

    The duration of effect from a single microinfarct was also a surprise for Shih’s team. “The MRI signal increased and then went away as we’d expected, but we were surprised on autopsy to see that there was still lots going on — tissue damage and neuroinflammation,” Shih explained. “Even after three weeks the neurally evoked blood flow responses had only partially recovered. So, that means a microinfarct can come and go and you can see it briefly with MRI but it leaves a lasting impression on brain function-possibly for months.”

    Importantly, a person with VCID is likely to experience other microinfarcts during this recovery time. Furthermore, these tiny infarcts occur not only in the brain’s grey matter, where this study was conducted, but also in the white matter, which sends messages from one part of the brain to another.

    “Over time, after you have a lot of microinfarcts, there may be enough accumulated damage in the brain’s circuitry to equal the impact of a larger event,” said Shih.

    According to Shih, one of the most important messages from this study is that conventional methods used in clinical trials do not reveal the entire impact that microinfarcts have on brain function. He hopes that his team’s contribution to illuminating microinfarct pathology will help inform MRI interpretation in humans and help researchers better explain some of the relationships that they see in clinical studies.

    These findings might also lead to new preventive protocols. “On a clinical level, maybe it’s a situation where therapeutics can play a bigger role. Maybe drugs that we already have can mitigate the cumulative damage of microinfarcts,” speculated Shih. “The neuro-protective idea hasn’t flown very far for acute stroke, in part, because the window of time for protecting the brain from stroke damage is very narrow. But, for microinfarcts, you don’t have to know exactly when they occur. If an MRI shows a person is at high risk for microinfarcts, maybe one day we can put them on a drug for a while to reduce the impacts of these lesions.”


  10. Depression as hard on the heart as obesity and cholesterol

    January 23, 2017 by Ashley

    From the Helmholtz Zentrum München – German Research Center for Environmental Health media release:

    Depression poses a risk for cardiovascular diseases in men that is just as great as that posed by high cholesterol levels and obesity. This is according to a report recently published in the Atherosclerosis journal by researchers from the Helmholtz Zentrum München, together with colleagues from the Technical University of Munich (TUM) and the German Center for Cardiovascular Disease (DZHK).

    According to the World Health Organisation WHO, 350 million people worldwide are affected by depression. But the mental state is not all that is affected, however, and depression can also compromise the body. “Meanwhile there is little doubt that depression is a risk factor for cardiovascular diseases,” explains Karl-Heinz Ladwig. He is group leader at the Institute of Epidemiology II at the Helmholtz Zentrum München, professor of psychosomatic medicine at TUM’s Klinikum rechts der Isar as well as scientist of DZHK. “The question now is: What is the relationship between depression and other risk factors like tobacco smoke, high cholesterol levels, obesity or hypertension — how big a role does each factor play?”

    In order to examine this question, Ladwig and his team analyzed data from 3,428 male patients between the ages of 45 and 74 years and observed their development over a period of ten years. “The work is based on a prospective population-based data set from the MONICA/KORA study that, with a total term of up to 25 years, is one of the few large studies in Europe that allows such an analysis,” reports the statistician Dr. Jens Baumert of Helmholtz Zentrum München, who was also involved in the publication.

    Investigate depression in high-risk patients

    In their analyses, the scientists compared the impact of depression with the four major risk factors. “Our investigation shows that the risk of a fatal cardiovascular disease due to depression is almost as great as that due to elevated cholesterol levels or obesity,” Ladwig summarizes. The results show that only high blood pressure and smoking are associated with a greater risk. Viewed across the population, depression accounts for roughly 15 percent of the cardiovascular deaths. “That is comparable to the other risk factors, such as hypercholesterolemia, obesity and smoking,” Ladwig states. These factors cause 8.4 to 21.4 percent of the cardiovascular deaths.

    “We invested a great deal of time in this work, just due to the long observation period,” says study leader Ladwig. But the effort paid off: “Our data show that depression has a medium effect size within the range of major, non-congenital risk factors for cardiovascular diseases.” Ladwig accordingly proposes consequences here: “In high risk patients, the diagnostic investigation of co-morbid depression should be standard. This could be registered with simple means.”