title: Factors related to prevalence, persistence, and incidence of depressive symptoms in mild cognitive impairment: vascular depression construct.
abstract: Depression is prevalent among elders with cognitive impairment. Cerebral white matter hyperintensities (WMH) have consistently been implicated in late-life depression and in cognitive impairment. This study aims to clarify the factors related to prevalence, persistence, and new onset of depressive symptoms in subjects with mild cognitive impairment (MCI).
  
  
  
  As part of a multicenter prospective study, the Clinical Research Center for Dementia of South Korea (CREDOS) Study, we enrolled 590 subjects diagnosed with MCI and with no prior history of depression. Depressive symptoms were assessed by the Korean version of the Geriatric Depression Scale short form (SGDS-K) at baseline and at follow-up visits. Brain magnetic resonance imaging was performed at baseline to quantify WMH using a visual rating scale.
  
  
  
  The baseline prevalence of clinically significant depressive symptoms (SGDS-K ≥5) was 51.4%, and this feature was associated with younger age, lower educational achievement, and higher Clinical Dementia Rating Sum of Boxes (CDR-SB) scores. Persistence of depressive symptoms across the study period was significantly associated with baseline CDR-SB and depression scores. New onset of depression (SGDS-K ≥8; incidence 15.7%) among subjects free of depressive symptoms (SGDS-K <5) at baseline was associated with severe deep subcortical, but not periventricular, WMH.
  
  
  
  In patients with MCI aged 50 years or older, depressive symptoms were highly prevalent. Cognitive status was closely related to both prevalence and persistence of depressive symptoms, while new onset of depression was associated with deep subcortical WMH severity in this MCI cohort. Our findings provide prospective evidence consistent with the vascular depression hypothesis. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sangha
authors.initials: S
authors.lastname: Kim
authors.affiliation: Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Korea.
authors.forename: Sook Young
authors.initials: SY
authors.lastname: Woo
authors.affiliation: Center for Clinical Research, Samsung Biomedical Research Institute, Seoul, Korea.
authors.forename: Hyo Shin
authors.initials: HS
authors.lastname: Kang
authors.affiliation: SAHIST, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Shin Won
authors.initials: SW
authors.lastname: Lim
authors.affiliation: Department of Neurology, Inha University School of Medicine, Incheon, Korea.
authors.forename: Seong Hye
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Woojae
authors.initials: W
authors.lastname: Myung
authors.affiliation: Department of Neurology, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Jee Hyang
authors.initials: JH
authors.lastname: Jeong
authors.affiliation: Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Yunhwan
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Chang Hyung
authors.initials: CH
authors.lastname: Hong
authors.affiliation: Department of Neurology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
authors.forename: Jong Hun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Neurology, Bobath Memorial Hospital, Seongnam, Korea.
authors.forename: HaeRi
authors.initials: H
authors.lastname: Na
authors.affiliation: Pacific Behavioral Research Foundation, Carmel, CA, USA.
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Carroll
authors.affiliation: Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Doh Kwan
authors.initials: DK
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000473:pathology* / Q000523:psychology*; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D056910:Republic of Korea / Q000453:epidemiology; D066127:White Matter / Q000473:pathology*
keywords: depression; depressive symptom; mild cognitive impairment; risk factor; vascular depression; white matter hyperintensities