TY - JOUR T1 - Cerebrovascular disease and evolution of depressive symptoms in the cardiovascular health study. JF - Stroke Y1 - 2002 A1 - Steffens, David C A1 - Krishnan, K Ranga Rama A1 - Crump, Casey A1 - Burke, Gregory L KW - Aged KW - Aged, 80 and over KW - Basal Ganglia Cerebrovascular Disease KW - Brain KW - Cerebrovascular Disorders KW - Cohort Studies KW - Comorbidity KW - Depression KW - Disease Progression KW - Female KW - Health Surveys KW - Humans KW - Incidence KW - Logistic Models KW - Magnetic Resonance Imaging KW - Male KW - Neuropsychological Tests KW - Odds Ratio KW - United States AB -

BACKGROUND AND PURPOSE: Previous studies have reported an association between cerebrovascular disease and depressive symptoms. The Cardiovascular Health Study (CHS) provides an opportunity to examine the relationship between vascular brain pathology seen on neuroimaging and changes in depressive symptoms.

METHODS: The sample included 3236 CHS participants who had an MRI brain scan. Demographic variables, medical history, functional status, and apolipoprotein E genotype were obtained at baseline. Annual scores on a modified version of the Centers for Epidemiologic Studies Depression (CES-D) scale were obtained initially and up to 7 years subsequently.

RESULTS: After controlling for important covariates, occurrence of depressive symptoms (defined as modified CES-D score of >7) was associated with small lesions in the basal ganglia, large cortical white-matter lesions, and severe subcortical white-matter grade. Neuroimaging variables did not predict incident depression among those who were nondepressive at the time of MRI. Persistence of depressive symptoms across 2 consecutive time points was associated with small basal ganglia lesions and large cerebral cortical white-matter lesions. Worsening of depression (increase in CES-D score of > or =5) was associated with subcortical white-matter lesions.

CONCLUSIONS: These findings suggest that cerebrovascular disease at baseline is related to depression symptoms over time. Further studies are needed to investigate the differential effects of subcortical white- versus gray-matter lesions on mood.

VL - 33 IS - 6 U1 - https://www.ncbi.nlm.nih.gov/pubmed/12053004?dopt=Abstract ER -