Temporal Lobe Atrophy and White Matter Lesions are Related to Major Depression Over 5 Years in the Elderly

Pernille Josefina Olesen (1) , Deborah Gustafson (1) , Michela Simoni (1) , Leonardo Pantoni (1) , Svante Östling (1) , Xinxin Guo (1) , Ingmar Skoog (1)

1 Psychiatry and neurochemistry

The influence of organic brain changes on the development of depression in the elderly is uncertain. Cross-sectional studies, most often from clinical samples, report associations with brain atrophy and cerebrovascular disease, while longitudinal population studies have given mixed results. Our aim was to investigate whether cortical atrophy and white matter lesions on computed tomography (CT) predict occurrence of depression in the elderly. This is a prospective population-based study with 5 years follow-up. The baseline sample included 525 elderly, age 70-86 years, without dementia or major depression and with a score on the Mini-Mental State Examination above 25, and without dementia at follow-up. Cortical atrophy and white matter lesions were evaluated at baseline using CT. The main outcome measure was development of major or minor depression at follow-up according to DSM-IV, as evaluated using neuropsychiatric examinations and hospital discharge registers. Logistic regression was used to estimate risk. Over 5 years, 20 individuals developed major and 63 minor depression. Presence of temporal lobe atrophy (odds ratio [OR] = 2.81, 95% confidence interval [CI] 1.04-7.62) and moderate-severe white matter lesions (OR = 3.21, 95% CI 1.00-10.26) independently predicted major, but not minor, depression after controlling for various confounders. Other brain changes did not predict occurrence of depression. Our findings suggest that temporal lobe atrophy and white matter lesions represent relatively independent and complementary pathways to major depression in the elderly. This may have implications for prevention, as both neurodegeneration and cerebrovascular disease has been related to preventable factors.

Mots clés: Aging; Geriatrics; Unipolar; Bipolar; Imaging; Clinical or Preclinical; Epidemiology; brain atrophy; longitudinal; white matter lesions; depression; population

Pernille Josefina Olesen, Deborah Gustafson, Michela Simoni, Leonardo Pantoni, Svante Östling, et al.. Temporal Lobe Atrophy and White Matter Lesions are Related to Major Depression Over 5 Years in the Elderly. Neuropsychopharmacology, 2010, ⟨10.1038/npp.2010.176⟩. ⟨hal-00580680⟩