Cognitive Reserve Moderates Effects of White Matter Hyperintensity on Depressive Symptoms and Cognitive Function in Late-Life Depression

Objective: Apathy symptoms are defined as a lack of interest and motivation. Patients with late-life depression (LLD) also suffer from lack of interest and motivation and previous studies have linked apathy to vascular white matter hyperintensities (WMH) of the brain in depressed and nondepressed patients. The aim of this study was to investigate the relationship between apathy symptoms, depressive symptoms, and WMH in LLD. We hypothesize that late-onset depression (LOD; first episode of depression after 55 years of age) is associated with WMH and apathy symptoms. Methods: Apathy scores were collected for 87 inpatients diagnosed with LLD. Eighty patients underwent brain magnetic resonance imaging. Associations between depressive and apathy symptoms and WMH were analyzed using linear regression. Results: All 3 subdomains of the 10-item Montgomery–Åsberg Depression Rating Scale correlated significantly with the apathy scale score (all P < .05). In the total sample, apathy nor depressive symptoms were related to specific WMH. In LOD only, periventricular WMH were associated with depression severity (β = 5.21, P = .04), while WMH in the left infratentorial region were associated with apathy symptoms (β coefficient = 5.89, P = .03). Conclusion: Apathy and depressive symptoms are highly overlapping in the current cohort of older patients with severe LLD, leading to the hypothesis that apathy symptoms are part of depressive symptoms in the symptom profile of older patients with severe LLD. Neither apathy nor depressive symptoms were related to WMH, suggesting that radiological markers of cerebrovascular disease, such as WMH, may not be useful in predicting these symptoms in severe LLD.

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White matter integrity and late-life depression in community-dwelling individuals: diffusion tensor imaging study using tract-based spatial statistics

The British Journal of Psychiatry ◽

10.1192/bjp.bp.113.142109 ◽

2014 ◽

Vol 205 (4) ◽

pp. 315-320 ◽

Cited By ~ 28

Author(s):

Simone Reppermund ◽

Lin Zhuang ◽

Wei Wen ◽

Melissa J. Slavin ◽

Julian N. Trollor ◽

...

Keyword(s):

Depressive Symptoms ◽

White Matter ◽

Spatial Statistics ◽

Late Life ◽

White Matter Integrity ◽

Late Life Depression ◽

White Matter Changes ◽

History Of ◽

Tract Based Spatial Statistics ◽

History Of Depression

BackgroundLate-life depression has been associated with white matter changes in studies using the regions of interest approach.AimsTo investigate the cross-sectional and longitudinal relationship between white matter integrity and depression in community-dwelling individuals using diffusion tensor imaging with tract-based spatial statistics.MethodThe sample comprised 381 participants aged between 72 and 92 years who were assessed twice within 2 years. Depressive symptoms were measured with the Geriatric Depression Scale. Tract-based spatial statistics were applied to investigate white matter integrity in currently depressed v. non-depressed elderly people and in those with a history of depression v. no history of depression. The relationship between white matter integrity and development of depressive symptoms after 2 years were analysed with logistic regression.ResultsIndividuals with current depression had widespread white matter integrity reduction compared with non-depressed elderly people. Significant fractional anisotropy reductions were found in 45 brain areas with the most notable findings in the frontal lobe, association and projection fibres. A history of depression was not associated with reduced fractional anisotropy. White matter changes in the superior frontal gyrus, posterior thalamic radiation, superior longitudinal fasciculus and in the body of corpus callosum predicted depression at follow-up.ConclusionsReduced white matter integrity is associated with late-life depression and predicts future depressive symptoms whereas a history of depression is not related to white matter changes. Disruption to white matter integrity may be a biomarker to predict late-life depression.

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348 - Increased White Matter Hyperintensity and Brain Resting-state fMRI Topology Changes in Suicide Attempters of Late-life Depression

International Psychogeriatrics ◽

10.1017/s1041610220002483 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 111-112

Author(s):

Chemin Lin ◽

Chih-Mao Huang ◽

Ho-Ling Anthony Liu ◽

Changwei W. Wu ◽

Cheng Hong Toh ◽

...

Keyword(s):

Cognitive Function ◽

Resting State ◽

Suicide Attempts ◽

Late Life ◽

Resting State Fmri ◽

White Matter Hyperintensity ◽

Late Life Depression ◽

Suicide Attempters ◽

Topology Changes ◽

History Of

Supported by (1) medical research grants CMRPG3C0041/42 from Chang Gung Memorial Hospital and NRRPG2H0031 from Ministry of Science and Technology, Taiwan to Chemin Lin (2) NMRPG3G6031/32 from Ministry of Science and Technology, Taiwan to Shwu-Hua, Lee (3) the KKHo International Charitable Foundation to Tatia Lee.Introduction:Suicide rate tends to peak in old age, and major depression is the most salient risk factor for late-life suicide. However, few studies have focused on the neuroscientific facet of suicide in the context of late-life depression (LLD).Methods:We recruited 114 participants of LLD (28 with history of suicide attempt and 86 without) and 47 elderly controls. They received MRI scanning and behavioral assessment. White matter hyperintensity (WMH) was quantified by an automated segmentation algorithm and graph theoretical analysis was applied to resting-state fMRI. We used ANCOVA to compare group difference in WMH loading and multivariate generalized linear model to compare global and local topological parameters in fMRI signals, controlling for demographics. Partial correlation was conducted between imaging parameters and behavioral data in group of suicide attempters.Results:We found significant higher WMH in suicide attempters than those of LLD without suicide attempts and elderly controls (F =7.091; p = 0.001). Suicide attempters also had increased betweenness centrality (BC) in right superior occipital gyrus (SOG) (Bonferroni corrected), right precuneus (False positive corrected) and right superior temporal gyrus (uncorrected) and decreased BC in left hippocampus (uncorrected). In suicide attempters, higher BC in right SOG correlated with higher WMH, higher depression severity, higher illness awareness and insight, and lower cognitive function (digit backward), while higher BC in right precuneus correlated with higher decrease awareness and insight and higher cognitive function (digit backward).Conclusion:Resonating with the vascular hypothesis in LLD, higher WMH was found in those having history of suicide attempts. However, the re-organized brain topology changes are related with divergent cognitive function and convergent heightened disease insight.

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Is the Clinical Expression of Late-Life Depression Influenced by Brain Changes? MRI Subcortical Neuroanatomical Correlates of Depressive Symptoms

International Psychogeriatrics ◽

10.1017/s1041610200006542 ◽

2000 ◽

Vol 12 (4) ◽

pp. 425-434 ◽

Cited By ~ 23

Author(s):

Steve Simpson ◽

Robert C. Baldwin ◽

Alan Jackson ◽

Alistair Burns ◽

Peter Thomas

Keyword(s):

Depressive Symptoms ◽

White Matter ◽

Late Onset ◽

Late Life ◽

Psychomotor Retardation ◽

First Episode ◽

Late Life Depression ◽

Clinical Expression ◽

Cross Sectional ◽

Vascular Depression

Background: “Vascular depression” has recently been proposed. It is characterized by magnetic resonance imaging (MRI) T2-weighted subcortical lesions, a late onset of first episode of depression, and reduced heritability; a cerebrovascular etiology is suggested. The validity of “vascular depression” might be strengthened if an association was found between the subcortical lesions used to define it and particular depressive symptoms. Methods: A blinded cross-sectional examination of DSM-III-R depressive symptoms (American Psychiatric Association, 1987) and MRI T2-weighted subcortical lesions in 44 patients with late-life depression. Results: Many associations were found; however, because of multiple comparisons, their significance is viewed with caution. The most robust finding was that psychomotor retardation was independently related to total white-matter score. The odds of showing psychomotor retardation was increased 1.9 times for every point increase in severity of white-matter change. Conclusion: In late-life depression the clinical expression of the depression is influenced by the pattern of MRI T2-weighted subcorticallesions. This gives some validity to the concept of an MRI-defined “vascular” subtype of late-life depression and strengthens the argument for including neuroimaging in the classification of late-life depression.

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Examining the association between late-life depressive symptoms, cognitive function, and brain volumes in the context of cognitive reserve

International Journal of Geriatric Psychiatry ◽

10.1002/gps.4192 ◽

2014 ◽

Vol 30 (6) ◽

pp. 614-622 ◽

Cited By ~ 33

Author(s):

Deirdre M. O'Shea ◽

Robert A. Fieo ◽

Jamie L. Hamilton ◽

Laura B. Zahodne ◽

Jennifer J. Manly ◽

...

Keyword(s):

Depressive Symptoms ◽

Cognitive Function ◽

Cognitive Reserve ◽

Late Life ◽

Brain Volumes

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Vascular risk factors and incident late-life depression in a Korean population

The British Journal of Psychiatry ◽

10.1192/bjp.bp.105.015032 ◽

2006 ◽

Vol 189 (1) ◽

pp. 26-30 ◽

Cited By ~ 61

Author(s):

Jae-Min Kim ◽

Robert Stewart ◽

Sung-Wan Kim ◽

Su-Jin Yang ◽

Il-Seon Shin ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Function ◽

Density Lipoprotein ◽

Late Life ◽

Diagnostic Interview ◽

Affective States ◽

Late Life Depression ◽

Lower Baseline ◽

Vascular Status

BackgroundCausal relationships between vascular factors and late-life depression are controversial.AimsTo investigate prospective associations between risk factors for vascular disease and incidence of late-life depression.MethodOf 661 community participants aged 65 years or over, without depression at baseline, 521 (79%) were re-evaluated 2 years later. At baseline and follow-up, a diagnostic interview for depression was carried out and information on vascular status, disability and cognitive function was gathered.ResultsPre-existing heart disease, incident stroke and lower baseline high-density lipoprotein cholesterol level were significantly associated with incidence of late-life depression, independently of disability and cognitive function.ConclusionsThese results provide some support for a vascular aetiology of late-life depression. However, important risk factors for cerebrovascular disease such as hypertension and diabetes were not implicated, and the associations with lipid levels might still be explained by affective states earlier in life.

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