[Association between depressive symptoms and cerebrovascular lesions on MRI in community-dwelling elderly individuals].
OBJECTIVE
We conducted a community-based study to verify relationships between cerebrovascular lesions (CVL) on magnetic resonance imaging and depressive symptoms (DS) in elderly individuals, and the validity of Krishnan's MRI-defined vascular depression (MRI-VD).


METHODS
MRI was performed in 196 community-dwelling elderly individuals (mean age, 72.3 +/- 1.7 years; range, 70-75 years) with a Mini Mental State (MMS) score of 22 or more who participated in the comprehensive geriatric assessment. The DS (+) group consisted of 41 subjects with Geriatric Depression Scale (GDS) score of 15 or more. The DS (-) group consisted of 141 subjects with a GDS score of 9 or less. Hyperintensities of deep white matter and subcortical gray matter were scored according to the modified Fazekas criteria. The CVL score was defined as the higher of the two scores, and 3 grades were defined as scores of 0, 1, or 2 or more. According to Krishnan's MRI-VD, a CVL score of 2 or more was defined as CVL (+). Logistic regression analyses were used to test associations between CVL and DS, and univariate analyses were used to examine differences in clinical features between CVL (+) and CVL (-) within the DS (+) group;


RESULTS
Logistic regression analysis adjusting for age, sex, cognitive function, educational level, instrumental activities of daily life (IADL) and subjective healthiness, CVL scores of 1 and 2 or more displayed significant associations with DS compared with a score of 0. However, no significant differences in DS were found between CVL (+) and CVL (-). Within the DS (+) group, no significant differences were noted between CVL (+) and CVL (-) in MMS, IADL, subjective healthiness, sleeping symptoms, alcohol-related problem or suicidal ideation.


CONCLUSIONS
CVL was associated with DS independent of various confounders. However, clarification of clinical profiles is required to define MRI-VD as an independent clinical entity.
Seki
Toru
T
Department of Psychiatry, Graduate School of Medicine, Tohoku University.
Awata
Shuichi
S
Koizumi
Yayoi
Y
Kinomura
Shigeo
S
Taki
Yasuyuki
Y
Hozawa
Atsushi
A
Ohmori
Kaori
K
Kuriyama
Shinichi
S
Fukuda
Hiroshi
H
Tsuji
Ichiro
I
D000368:Aged; D001921:Brain / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000523:psychology*; D003863:Depression; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011569:Psychiatric Status Rating Scales