Epidemiology of MRI-defined vascular depression: A longitudinal, community-based study in Korean elders.
BACKGROUND
There are no cross-sectional or longitudinal epidemiological studies present on MRI-defined vascular depression in community populations. The purpose of this study was to estimate the prevalence rates of both vascular and non-vascular late life depression (LLD) at baseline, to examine the natural course of LLD, and to investigate the influence of White matter hyperintensities (WMHs) on depression after three years.


METHODS
The baseline study employed a two-stage design, Phase I population survey (n=783) and Phase II diagnostic evaluation (n=122). In the 3-year follow-up study, baseline participants completing the second phase were reassessed with the same methodology. WMHs severity was rated visually by the modified Fazekas scale and WMHs volume was calculated using an automated method.


RESULTS
The prevalence rates of vascular major depressive disorder (MDD) and vascular non-major depressive disorder (nMDD) were 2.39% (56.2% of MDD) and 4.24% (34.0% of nMDD). Subjects with a score of 2 or more on the modified Fazekas scale in either deep white matter hyperintensities or subcortical gray matter ratings had an 8.1 times greater risk of developing a depressive disorder in the 3-year follow-up study. Greater Log WMHs volume (odds ratio=5.78, 95% CI, 1.04-31.72) at baseline was an independent predictor for depressive disorder in the 3-year assessment.


CONCLUSIONS
Response rate and follow-up rate were relatively low.


CONCLUSIONS
Vascular depression is common and makes up about a half of MDD in elders. Greater WMHs severity is a crucial factor predicting future depression risk, which supports the previous vascular depression hypothesis.
Department of Psychiatry, Jeju National University School of Medicine, Jeju National University Hospital, Jejudo, Korea.
Joon Hyuk
JH
Park
Department of Psychiatry, Dankook University College of Medicine, Dankook University Hospital (Chungcheongnamdo), Korea.
Seok Bum
SB
Lee
Department of Psychiatry, Dankook University College of Medicine, Dankook University Hospital (Chungcheongnamdo), Korea.
Jung Jae
JJ
Lee
Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Gyeonggido, Korea.
Jong Chul
JC
Yoon
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.
Ji Won
JW
Han
Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea.
Tae Hui
TH
Kim
Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Korea University, Seoul, Korea.
Hyun-Ghang
HG
Jeong
The Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN, USA; Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University, Nashville, TN, USA.
Paul A
PA
Newhouse
The Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN, USA; Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University, Nashville, TN, USA.
Warren D
WD
Taylor
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
Jae Hyoung
JH
Kim
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.
Jong Inn
JI
Woo
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea. Electronic address: kwkimmd@snu.ac.kr.
Ki Woong
KW
Kim
D000368:Aged; D000369:Aged, 80 and over; D001479:Basal Ganglia / Q000473:pathology; D001921:Brain / Q000473:pathology; D002552:Cerebral Ventricles / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D056910:Republic of Korea / Q000453:epidemiology
Epidemiology; Prevalence; Risk; Vascular depression; White matter hyperintensities