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Cerebral White Matter Lesions and Depressive Symptoms in Elderly Adults
Jan Cees de Groot, MD, PhD;
Frank-Erik de Leeuw, MD, PhD;
Matthijs Oudkerk, MD, PhD;
Albert Hofman, MD, PhD;
Jellemer Jolles, PhD;
Monique M. B. Breteler, MD, PhD
Arch Gen Psychiatry. 2000;57:1071-1076.
Background There is evidence for a vascular cause of late-life depression. Cerebral white matter lesions are thought to represent vascular abnormalities. White matter lesions have been related to affective disorders and a history of late-onset depression in psychiatric patients. Their relation with mood disturbances in the general population is not known. We investigated the relation between white matter lesions and the presence of depressive symptoms or a history of depression in a population-based study.
Methods In a sample of 1077 nondemented elderly adults, we assessed the presence and severity of subcortical and periventricular white matter lesions using magnetic resonance imaging, presence of depressive symptoms, and history of depression. Using multiple regression analysis, we examined the relation among white matter lesions, depressive symptoms, and history of depression.
Results Most of the subjects had white matter lesions. Persons with severe white matter lesions (upper quintile) were 3 to 5 times more likely to have depressive symptoms as compared with persons with only mild or no white matter lesions (lowest quintile) (periventricular odds ratio [OR] = 3.3; 95% confidence interval [CI], 1.2-9.5; subcortical OR = 5.4; 95% CI, 1.8-16.5). In addition, persons with severe subcortical but not periventricular white matter lesions were more likely to have had a history of depression with an onset after age 60 years (OR = 3.4; 95% CI, 1.1-10.7) compared with persons with only mild or no white matter lesions.
Conclusion The severity of subcortical white matter lesions is related to the presence of depressive symptoms and to a history of late-onset depression.
From the Departments of Epidemiology and Biostatistics (Drs de Groot, de Leeuw, Hofman, and Breteler) and Radiology (Dr Oudkerk), Erasmus University Medical School, Rotterdam, the Netherlands; and the Department of Neuropsychology, Neuropsychiatry, and Psychobiology (Dr Jolles), University Maastricht, the Netherlands.
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