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Cerebrovascular disease and depression symptoms in the cardiovascular health study
D C Steffens1, M J Helms, K R Krishnan
1Department of Psychiatry, Duke University Medical Center, Durham, NC USA.
Insights
Small lesions in the basal ganglia are linked to depressive symptoms in older adults. This finding highlights the importance of cerebrovascular changes in geriatric depression.
Area of Science:
- Geriatric Medicine
- Neurology
- Psychiatry
Background:
- Cerebrovascular disease is increasingly linked to depressive symptoms in the elderly.
- Both white and gray matter lesions are associated with depression.
Purpose of the Study:
- Investigate the relationship between depressive symptoms and white/gray matter lesions.
- Examine associations in a large, community-based population.
Main Methods:
- MRI scans and a modified Centers for Epidemiologic Studies Depression (CES-D) scale were used.
- 3660 participants were analyzed, controlling for demographic and medical variables.
Main Results:
- A significant association was found between the number of small basal ganglia lesions (<3 mm) and depressive symptoms.
- White matter grade was not significantly associated with depressive symptoms.
- Basal ganglia lesions remained a significant predictor after controlling for other variables.
Conclusions:
- Findings extend previous reports to a community-based population.
- Provides further evidence for the role of basal ganglia lesions in geriatric depression.
Background And Purpose:
Evidence is mounting linking cerebrovascular disease with depressive symptoms in the elderly. Lesions in both white and gray matter have been associated with depressive symptoms and major depression. We sought to investigate the relationship between depressive symptoms and white and gray matter lesions in subjects participating in the Cardiovascular Health Study.
Methods:
In a sample of 3660 men and women who underwent a standardized interview, physical examination, and MRI scan, we examined the association between number of white and gray matter lesions and white matter grade (a measure of severity) and reported depressive symptoms using a modified version of the Centers for Epidemiologic Studies Depression (CES-D) scale. We controlled for a variety of demographic and medical variables as well as functional status and Modified Mini-Mental State Examination score.
Results:
The number of small (<3 mm) basal ganglia lesions was significantly associated with reported depressive symptoms, but white matter grade was not. In subsequent logistic regression models, number of basal ganglia lesions remained a significant predictor after controlling for non-MRI variables and severity of white matter lesions.
Conclusions:
Our findings extend previous reports that linked cerebrovascular changes to depressive symptoms in clinical populations to a large community-based population. This report provides further evidence of the importance of basal ganglia lesions in geriatric depression.