Abstract

Objective: Vascular burden is associated with cognitive deficits and a form of late-life depression, vascular depression (VaDep), which is marked by decreased white matter integrity, executive dysfunction, poor treatment response, and functional disability. Older Black Americans represent a vulnerable population at risk of developing VaDep, but the literature in this group is limited. Thus, the goal of this systematic review is to summarize the existing literature that informs our understanding of VaDep in older Black Americans, including cognitive, functional, and psychosocial outcomes. Method: Following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, studies were identified that examined the relationship between vascular disease or vascular risk factors and that either had a sample of at least 75% Black participants or conducted race-specific analyses. Thirty studies met all inclusion criterion based on review of both authors. Results: Overall, studies support the construct of VaDep in older Black Americans. There is preliminary support for VaDep-related cognitive and functional deficits, and mixed findings regarding racial disparities in prevalence of VaDep. Conclusion: This review underscores the need for further neuroimaging and neuropsychological research in Black older adults with comorbid depression and vascular disease. Findings also highlight the importance of screening for depressive symptoms in Black individuals with multiple vascular risk factors.

摘要

目的：血管负担与认知缺陷和一种晚年抑郁症、血管性抑郁症 (VaDep) 相关，其特点是白质完整性下降、执行功能障碍、治疗反应差和功能障碍。年长的美国黑人代表了面临 VaDep 风险的弱势群体，但该群体的文献有限。因此，本系统综述的目的是总结现有文献，以加深我们对美国老年黑人 VaDep 的理解，包括认知、功能和心理社会结果。方法：按照系统评价和荟萃分析指南的首选报告项目，确定了研究血管疾病或血管危险因素之间关系的研究，并且样本至少有 75% 的黑人参与者或进行了种族特异性分析。根据两位作者的审查，三十项研究符合所有纳入标准。结果：总体而言，研究支持美国老年黑人中 VaDep 的构建。初步支持 VaDep 相关的认知和功能缺陷，并且关于 VaDep 患病率的种族差异存在不同的结果。结论：本综述强调需要对患有抑郁症和血管疾病的黑人老年人进行进一步的神经影像学和神经心理学研究。研究结果还强调了对具有多种血管危险因素的黑人进行抑郁症状筛查的重要性。