Vascular brain disease and depression in the elderly.
BACKGROUND
Cross-sectional studies have shown an association between vascular brain disease and depression. Longitudinal data are scarce. In a population-based study we investigated this relationship both cross-sectionally and longitudinally.


METHODS
Brain MRIs were administered to 479 persons aged 60-90 years at baseline (1995-1996). Brain atrophy, white matter lesions and brain infarcts are all markers of vascular brain disease. At baseline and at follow-up examinations, we also identified persons with depressive symptoms and syndromes using the Center for Epidemiological Studies Depression Scale and psychiatric interviews. Medical records were continuously monitored to identify incident depression. Follow-up was complete until October 2005.


RESULTS
At baseline, 36 persons had depressive symptoms. Brain atrophy, white matter lesions, and infarcts were associated with presence of depressive symptoms. During follow-up, 92 persons developed depressive symptoms, 35 of whom were categorized as having depressive syndrome. There was no association of any MRI marker with incident depressive symptoms or syndromes.


CONCLUSIONS
Markers of vascular brain disease were associated with depression cross-sectionally. However, when these markers and risk of depression were assessed longitudinally, no relationship was found.
Ikram
M Arfan
MA
Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Luijendijk
Hendrika J
HJ
Vernooij
Meike W
MW
Hofman
Albert
A
Niessen
Wiro J
WJ
van der Lugt
Aad
A
Tiemeier
Henning
H
Breteler
Monique M B
MM
D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008485:Medical Audit; D009426:Netherlands / Q000453:epidemiology; D018570:Risk Assessment