title: Factors associated with brain volume in major depression in older adults without dementia: results from a large autopsy study.
abstract: OBJECTIVE
  We examined brain volume and atrophy in individuals with major depressive disorder (MDD) without dementia that were referred to a large autopsy service. We also examined potential risk factors for brain atrophy, including demographics and clinical variables.
  
  
  METHODS
  In this study, 1373 participants (787 male) aged 50 years or older who died from natural causes were included. Participants with no reliable informant, with cognitive impairment or dementia, with a medical history of severe chronic disease, or with prolonged agonal state were excluded. Presence of MDD at least once in their lifetime was defined according to the Structured Clinical Interview for DSM. Brain volume was measured immediately after removal from the skull.
  
  
  RESULTS
  Mean age at death was 68.6 ± 11.6, and MDD was present in 185 (14%) individuals. Smaller brain volume was associated with older age (p < 0.001), lower education (years; p < 0.001), hypertension (p = 0.001), diabetes (p = 0.006), and female gender (p < 0.001). In the multivariate analysis adjusted for sociodemographics and cardiovascular risk factors, smaller brain volume was not associated with major depression (β = -0.86, 95% CI = -26.50 to 24.77, p = 0.95).
  
  
  CONCLUSIONS
  In this large autopsy study of older adults, MDD was not associated with smaller brain volumes. Regardless of the presence of MDD, in this sample of older adults without dementia, we found that smaller brain volumes were associated with risk factors for brain neurodegeneration such as older age, diabetes, hypertension, and lower education. Copyright © 2017 John Wiley & Sons, Ltd.
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Paula Villela
authors.initials: PV
authors.lastname: Nunes
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Claudia Kimie
authors.initials: CK
authors.lastname: Suemoto
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Renata Elaine Paraizo
authors.initials: REP
authors.lastname: Leite
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Renata Eloah de Lucena
authors.initials: REL
authors.lastname: Ferretti-Rebustini
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Carlos Augusto
authors.initials: CA
authors.lastname: Pasqualucci
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Nitrini
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Jose Marcelo
authors.initials: JM
authors.lastname: Farfel
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Katia Cristina
authors.initials: KC
authors.lastname: de Oliveira
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.|Memory and Aging Center University of California, San Francisco, CA, USA.
authors.forename: Lea Tenenholz
authors.initials: LT
authors.lastname: Grinberg
authors.affiliation: Faculdade de Medicina de Jundiai, Jundiai, Brazil.
authors.forename: Nicole Rezende
authors.initials: NR
authors.lastname: da Costa
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Camila Fernandes
authors.initials: CF
authors.lastname: Nascimento
authors.affiliation: Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Faraz
authors.initials: F
authors.lastname: Salmasi
authors.affiliation: Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Helena Kyunghee
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Lionel Trevor
authors.initials: LT
authors.lastname: Young
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Wilson
authors.initials: W
authors.lastname: Jacob-Filho
authors.affiliation: University of São Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Beny
authors.initials: B
authors.lastname: Lafer
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology; D001284:Atrophy / Q000473:pathology; D001344:Autopsy; D001921:Brain / Q000473:pathology*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000473:pathology*; D003920:Diabetes Mellitus / Q000473:pathology; D004522:Educational Status; D005260:Female; D006801:Humans; D006973:Hypertension / Q000473:pathology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009929:Organ Size; D012307:Risk Factors
keywords: brain volume; diabetes; elderly; hypertension; major depression; postmortem