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Computed tomography in the elderly. 3. Affective disorder

R J Jacoby, R Levy

    The British Journal of Psychiatry : the Journal of Mental Science
    |March 1, 1980
    PubMed
    Summary
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    Clinical and neuropathological correlates of depression in Alzheimer's disease.

    Psychological medicine·1992

    This study found that enlarged ventricles in elderly patients with affective disorders may indicate organic cerebral factors contributing to late-onset depression. This contrasts with healthy aging, where sulcal widening correlates with age.

    Area of Science:

    • Neuroscience
    • Geriatrics
    • Psychiatry

    Background:

    • Affective disorders are common in the elderly.
    • Brain structure changes with age, but the relationship with affective disorders requires further investigation.
    • Cerebrovascular disease prevalence in elderly psychiatric patients is not well-established.

    Purpose of the Study:

    • To compare brain structure (ventricular size, sulcal widening) in elderly patients with affective disorders and healthy controls.
    • To investigate the prevalence of cerebrovascular disease in this patient group.
    • To explore potential links between brain changes, clinical features, and the onset of depression in old age.

    Main Methods:

    • Clinical data and computed tomographic (CT) scans were collected from 41 elderly patients with affective disorders and 50 healthy controls.

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  • Ventricular size and sulcal widening were assessed.
  • Cerebrovascular disease was diagnosed using clinical and radiological criteria.

    • Main Results:

    • Ventricular size increased with age in both patients and controls.
    • Age-related sulcal widening was observed only in healthy controls.
    • Cerebrovascular disease was present in 12% of the patient group.
    • A subgroup of patients with enlarged ventricles, later onset of depression, and more endogenous features was identified.

    Conclusions:

    • Organic cerebral factors, indicated by enlarged ventricles, may play a role in the etiology of some late-onset depressions.
    • Brain structural changes in elderly patients with affective disorders may differ from those in healthy aging.
    • Further research is needed to elucidate the role of cerebrovascular disease and other organic factors in geriatric depression.