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Int. J. Mol. Sci. 2019, 20(8), 1905; https://doi.org/10.3390/ijms20081905

Low-Grade Inflammation Is Associated with Apathy Indirectly via Deep White Matter Lesions in Community-Dwelling Older Adults: The Sefuri Study

1
Division of Clinical Research, National Hospital Organization Hizen Psychiatric Center, Saga 842-0192, Japan
2
Department of Psychiatry, Faculty of Medicine, Saga University, Saga 849-8501, Japan
3
Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga 849-8501, Japan
4
Department of Diagnostic Radiology, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
*
Author to whom correspondence should be addressed.
Received: 9 April 2019 / Accepted: 15 April 2019 / Published: 17 April 2019
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Abstract

Low-grade inflammation is implicated in the pathogenesis of atherosclerosis, metabolic syndrome, and apathy as a form of vascular depression. We analyzed the brain magnetic resonance imaging findings in 259 community-dwelling older adults (122 men and 137 women, with a mean age of 68.4 years). The serum concentrations of high-sensitivity C-reactive protein (hsCRP) were measured by a quantitative enzyme-linked immunosorbent assay. Logistic regression analysis revealed that the log10 hsCRP value and the presence of a metabolic syndrome were independently associated with confluent but not punctate deep white matter lesions (DWMLs). Path analysis based on structural equation modeling (SEM) indicated that the direct path from the log10 hsCRP to the DWMLs was significant (β = 0.119, p = 0.039). The direct paths from the metabolic syndrome to the log10 hsCRP and to the DWMLs were also significant. The direct path from the DWMLs to apathy (β = −0.165, p = 0.007) was significant, but the direct path from the log10 hsCRP to apathy was not significant. Inflammation (i.e., elevated serum hsCRP levels) was associated with DWMLs independent of common vascular risk factors, while DWMLs were associated with apathy. The present analysis with SEM revealed the more realistic scheme that low-grade inflammation was associated with apathy indirectly via DWMLs in community-dwelling older adults. View Full-Text
Keywords: physical activity; apathy; vascular depression; vascular cognitive impairment; white matter lesions; magnetic resonance imaging; small vessel disease; silent stroke physical activity; apathy; vascular depression; vascular cognitive impairment; white matter lesions; magnetic resonance imaging; small vessel disease; silent stroke
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Yao, H.; Mizoguchi, Y.; Monji, A.; Yakushiji, Y.; Takashima, Y.; Uchino, A.; Yuzuriha, T.; Hashimoto, M. Low-Grade Inflammation Is Associated with Apathy Indirectly via Deep White Matter Lesions in Community-Dwelling Older Adults: The Sefuri Study. Int. J. Mol. Sci. 2019, 20, 1905.

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