White Matter Lesions as a Predictor of Depression in the Elderly: The 3C-Dijon Study
Biological Psychiatry. 2008-04-01; 63(7): 663-669
DOI: 10.1016/j.biopsych.2007.09.006
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1. Biol Psychiatry. 2008 Apr 1;63(7):663-9. Epub 2007 Oct 30.
White matter lesions as a predictor of depression in the elderly: the 3C-Dijon
study.
Godin O(1), Dufouil C, Maillard P, Delcroix N, Mazoyer B, Crivello F, Alpérovitch
A, Tzourio C.
Author information:
(1)Neuroepidemiology, Institut National de Santé et de Recherche Médicale, Paris,
France.
BACKGROUND: There is increasing evidence for a link between cerebrovascular
disease and depression in the elderly but the mechanisms are still unknown. This
study examines the longitudinal relationship between depression and white matter
lesions (WML) in a sample of elderly aged 65 years and older.
METHODS: Three City (3C)-Dijon is a 4-year follow-up population-based prospective
study of 1658 subjects. At baseline, lifetime major depressive episode diagnosis
was established using the Mini International Neuropsychiatric Interview. At each
study wave, severity of depressive symptoms was assessed using Center for
Epidemiological Studies-Depression (CES-D), and antidepressants intake was
recorded. At baseline, lifetime major depression (LMD) was defined as lifetime
major depressive episode or antidepressant medication intake. At follow-up,
subjects were classified “incident depression” if scoring high at CES-D or
antidepressant users. At baseline, cerebral magnetic resonance imaging (MRI) was
performed to quantify WML volumes using an automated method of detection. At
4-year follow-up, 1214 subjects had a second MRI.
RESULTS: Cross-sectional analysis showed a significantly higher WML volume in
subjects with LMD compared with other subjects. Adjusted longitudinal analysis
showed that increase in WML load was significantly higher in subjects with
baseline LMD (2.1 cm(3) vs. 1.5 cm(3), p = .004). Among subjects free of
depression up to baseline (n = 956), the higher the baseline WML volume, the
higher the risk of developing depression during follow-up (odds ratio one
quartile increase: 1.3; 95% confidence interval: = 1.1-1.7).
CONCLUSIONS: Our data show that depression and WML volumes are strongly related.
These results are consistent with the hypothesis of a vascular depression in the
elderly.
DOI: 10.1016/j.biopsych.2007.09.006
PMID: 17977521 [Indexed for MEDLINE]