Background: Growing evidence suggests that cerebral white-matter changes and depressive symptoms are linked directly along the causal pathway. We investigated whether baseline severity of cerebral white-matter changes predict longer-term future depressive outcomes in a community sample of non-disabled older adults.Method In the Leukoaraiosis and Disability in the Elderly (LADIS) study, a longitudinal multi-centre pan-European study, 639 older subjects underwent baseline structural magnetic resonance imaging (MRI) and clinical assessments. Baseline severity of white-matter changes was quantified volumetrically. Depressive outcomes were assessed in terms of depressive episodes and depressive symptoms, as measured by the Geriatric Depression Scale (GDS). Subjects were clinically reassessed annually for up to 3 years. Regression models were constructed to determine whether baseline severity of white-matter changes predicted future depressive outcomes, after controlling for confounding factors.Results Baseline severity of white-matter changes independently predicted depressive symptoms at both 2 (p<0.001) and 3 years (p=0.015). Similarly, white-matter changes predicted incident depression (p=0.02). Over the study period the population became significantly more disabled (p<0.001). When regression models were adjusted to account for the influence of the prospective variable transition to disability, baseline severity of white-matter changes no longer predicted depressive symptoms at 3 years (p=0.09) or incident depression (p=0.08).Conclusions Our results support the vascular depression hypothesis and strongly implicate white-matter changes in the pathogenesis of late-life depression. Furthermore, the findings indicate that, over time, part of the relationship between white-matter changes and depression may be mediated by loss of functional activity.
Relationship between baseline white-matter changes and development of late-life depressive symptoms : 3-year results from the LADIS study / A. Teodorczuk, M.J. Firbank, L. Pantoni, A. Poggesi, T. Erkinjuntti, A. Wallin, L.O. Wahlund, P. Scheltens, G. Waldemar, G. Schrotter, J.M. Ferro, H. Chabriat, H. Bazner, M. Visser, D. Inzitari, J.T. O'Brien. - In: PSYCHOLOGICAL MEDICINE. - ISSN 0033-2917. - 40:4(2010 Apr), pp. 603-610.
|Titolo:||Relationship between baseline white-matter changes and development of late-life depressive symptoms : 3-year results from the LADIS study|
|Parole Chiave:||Disability; Late-life depression; Longitudinal study; MRI; White-matter lesions; Age of Onset; Aged; Aged, 80 and over; Brain; Depressive Disorder, Major; Disability Evaluation; Female; Humans; Magnetic Resonance Imaging; Male; Severity of Illness Index; Surveys and Questionnaires; Applied Psychology; Psychiatry and Mental Health|
|Settore Scientifico Disciplinare:||Settore MED/26 - Neurologia|
|Data di pubblicazione:||apr-2010|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1017/S0033291709990857|
|Appare nelle tipologie:||01 - Articolo su periodico|