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Am J Geriatr Psychiatry. 2017 Dec;25(12):1311-1321. doi: 10.1016/j.jagp.2017.06.003. Epub 2017 Jul 5.

White Matter Lesions are Associated with Specific Depressive Symptom Trajectories among Incident Depression and Dementia Populations: Three-City Dijon MRI Study.

Author information

1
Bordeaux Population Health, University of Bordeaux, INSERM U1219, Bordeaux, France; Department of Neuroepidemiology, University of Bordeaux, INSERM U1219, Bordeaux, France; Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia. Electronic address: phillip.tully@adelaide.edu.au.
2
Bordeaux Population Health, University of Bordeaux, INSERM U1219, Bordeaux, France; Department of Neuroepidemiology, University of Bordeaux, INSERM U1219, Bordeaux, France; Department of Neurology, Bordeaux University Hospital, Bordeaux, France; Department of Neurology, Framingham Heart Study, Boston University School of Medicine, Boston, MA.
3
Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, Bordeaux, France.
4
Bordeaux Population Health, University of Bordeaux, INSERM U1219, Bordeaux, France; Department of Neuroepidemiology, University of Bordeaux, INSERM U1219, Bordeaux, France.

Abstract

OBJECTIVE:

Evidence is mixed as to whether periventricular or deep white matter hyperintensities (WMHs) increase the risk for depressive symptoms, partly because of heterogeneity in depression measurement, short follow-up, and confounding by prodromal dementia. The study objective was to evaluate WMH volume in relation to discrete depressive symptoms over 10 years, stratifying by incident depression and dementia.

METHODS:

In this prospective longitudinal cohort study of a representative population sample from Dijon, France, 1,440 participants aged 65-80 years (median age: 72 years; 59.5% women) without depression, dementia, or stroke at baseline were studied. Baseline T2-weighted images were obtained in a 1.5-T scanner to quantify WMHs (log cm3). Clinic visits were performed up to five times in a 10-year period to assess incident neurologic diseases and comorbidities. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale and converted to factor z scores, representing somatic symptoms, depressed affect, low positive affect, and interpersonal problems.

RESULTS:

Periventricular WMH volume was uniquely associated with low positive affect among incident depression cases (β = 0.15; 95% confidence interval [CI]: 0.02-0.29; p = 0.026). Deep WMH volume was uniquely associated with depressed affect among incident dementia cases (β = 0.36; 95% CI: 0.05-0.68; p = 0.025). WMH volume (periventricular, deep, and total) was associated with interpersonal problems among persons who developed dementia with depression.

CONCLUSION:

The findings highlight that regional WMH volumes and specific depressive symptoms have clinical and prognostic relevance to help differentiate between persons at risk for depression and dementia.

KEYWORDS:

Depression; cerebrovascular disease; dementia; geriatric psychiatry; longitudinal; white matter hyperintensity

PMID:
28688824
DOI:
10.1016/j.jagp.2017.06.003
[Indexed for MEDLINE]

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