title: Depressive symptoms, symptom dimensions, and white matter lesion volume in older adults: a longitudinal study.
abstract: OBJECTIVE
  White matter lesions (WMLs) are associated with depressive symptoms in older adults. However, it is not clear whether different symptom dimensions of depression have distinct associations with WMLs. The authors assessed the longitudinal relationships of the Center for Epidemiologic Studies Depression Scale (CES-D) total score and subscale scores with WML volume in the Baltimore Longitudinal Study of Aging.
  
  
  METHODS
  Using a prospective observational design, the authors examined WML volume and depressive symptoms at 1- to 2-year intervals for up to 9 years in 116 dementia-free participants (mean age: 68.78 ± 7.68). At each visit, depressive symptoms were measured with the CES-D and WML volumes were quantified from structural magnetic resonance imaging scans.
  
  
  RESULTS
  Higher CES-D full-scale scores were associated with greater WML volume and with a faster rate of volume increases over time in women, especially at older ages. Higher depressed mood and somatic symptoms subscale scores were associated with greater increases in WML volume over time at older ages. In men, depressed mood and somatic symptoms were associated with larger WML volume at baseline.
  
  
  CONCLUSIONS
  Findings confirm an association between WMLs and depressive symptoms and suggest that depressed mood and somatic symptoms may be stronger predictors of depression-related brain changes than lack of well-being. Age and sex may moderate the relationships between depressive symptoms and WMLs. Understanding particular symptom dimensions of depressive symptoms has implications for treatment and may lead to targeted interventions and more precise knowledge of mechanisms underlying depression.
authors.affiliation: Department of Clinical & Health Psychology, University of Florida, Gainesville, FL.
authors.forename: Joshua W
authors.initials: JW
authors.lastname: Kirton
authors.affiliation: Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Resnick
authors.affiliation: Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA.
authors.forename: Christos
authors.initials: C
authors.lastname: Davatzikos
authors.affiliation: Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kraut
authors.affiliation: Department of Clinical & Health Psychology, University of Florida, Gainesville, FL. Electronic address: vonetta@phhp.ufl.edu.
authors.forename: Vonetta M
authors.initials: VM
authors.lastname: Dotson
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology*; D003863:Depression / Q000503:physiopathology*; D005260:Female; D006801:Humans; D056784:Leukoencephalopathies / Q000473:pathology*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
keywords: Depression; MRI; WML; aging; symptom dimensions