title: Medial temporal lobe atrophy and depressive symptoms in elderly patients with and without Alzheimer disease.
abstract: OBJECTIVE
  To determine whether depressive symptoms are associated with medial temporal lobe atrophy in older people with and without Alzheimer disease (AD).
  
  
  METHODS
  A total of 368 memory clinic patients with AD, mild cognitive impairment, and subjective cognitive impairment (SCI) were included. Depressive symptoms were defined as a score of 8 or higher on Cornell Scale for Depression in Dementia or use of antidepressant medications. Magnetic resonance imaging and computer tomography scans were rated for medial temporal lobe atrophy (MTA), using the Scheltens scale. For a subsample (n = 57 patients), hippocampal volume was manually traced.
  
  
  RESULTS
  Based on visual assessment, AD patients with depressive symptoms had less atrophy of the right medial temporal lobe (odds ratio [OR] for having MTA: 0.39; 95% confidence interval [CI] 0.16-0.99) and decreased scores on Scheltens scale for the left medial temporal lobe (OR: 0.43, 95% CI 0.19-0.96) in comparison to AD patients without depressive symptoms. In the subgroup where manual tracing was used to measure hippocampal volume, people with SCI experiencing depressive symptoms had smaller right (mean difference: 0.28 cm(3); P = .005) and left (mean difference 0.32 cm(3); P = .002) hippocampal volumes compared to people with SCI who did not have depressive symptoms.
  
  
  CONCLUSIONS
  Hippocampal atrophy was more pronounced among patients having SCI with depressive symptoms, while the medial temporal lobe was less atrophic in patients having AD with depressive symptoms than those without depressive symptoms. These findings suggest that different mechanisms underlie depression in older people with and without AD and may explain some of the inconsistent observations in previous studies.
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Carol Davila University of Medicine and Pharmacy, Department of Psychiatry, Bucharest, Romania.
authors: Daniela
authors: D
authors: Enache
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Radiology, Karolinska University Hospital, Stockholm, Sweden.
authors: Lena
authors: L
authors: Cavallin
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors: Olof
authors: O
authors: Lindberg
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors: Bahman
authors: B
authors: Farahmand
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Neurology, University Medical Centre, Ljubljana, Slovenia.
authors: Milica Gregoric
authors: MG
authors: Kramberger
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors: Eric
authors: E
authors: Westman
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Geriatric Medicine, Memory Clinic, Karolinska University Hospital-Huddinge, Stockholm, Sweden.
authors: Vesna
authors: V
authors: Jelic
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Geriatric Medicine, Memory Clinic, Karolinska University Hospital-Huddinge, Stockholm, Sweden.
authors: Maria
authors: M
authors: Eriksdotter
authors: Wolfson Centre for Age-Related Diseases, King's College London, United Kingdom.
authors: Clive
authors: C
authors: Ballard
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Geriatric Medicine, Memory Clinic, Karolinska University Hospital-Huddinge, Stockholm, Sweden.
authors: Bengt
authors: B
authors: Winblad
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Geriatric Medicine, Memory Clinic, Karolinska University Hospital-Huddinge, Stockholm, Sweden.
authors: Lars-Olof
authors: LO
authors: Wahlund
authors: Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Department of Geriatric Medicine, Memory Clinic, Karolinska University Hospital-Huddinge, Stockholm, Sweden Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway dag.aarsland@ki.se.
authors: Dag
authors: D
authors: Aarsland
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology; D001284:Atrophy / Q000473:pathology*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000473:pathology; D060825:Cognitive Dysfunction; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011379:Prognosis; D013702:Temporal Lobe / Q000473:pathology*
keywords: Alzheimer disease; depression; elderly; hippocampus