Cerebral white matter lesions and depressive symptoms in elderly adults
Cerebral white matter lesions and depressive symptoms in elderly adults
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DOI：
10.1001/archpsyc.57.11.1071
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发表时间：
2000-11-01
影响因子：
--
通讯作者：
Breteler, MMB
中科院分区：
文献类型：
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作者：
de Groot, JC;de Leeuw, FE;Breteler, MMB
背景：有证据表明晚年抑郁与血管有关。脑白质病变被认为代表血管异常。白质病变与精神病人的情感性障碍和迟发性抑郁史有关。它们与普通人群情绪障碍的关系尚不清楚。我们在一项基于人群的研究中调查了白质病变与抑郁症状或抑郁史之间的关系。方法：在1077名非痴呆老年人的样本中，我们使用磁共振成像评估皮质下和脑室周围白质病变的存在和严重程度，抑郁症状的存在和抑郁史。使用多元回归分析，我们检验了白质病变、抑郁症状和抑郁史之间的关系。结果：多数受试者出现脑白质病变。重度白质病变患者（上五分位数）出现抑郁症状的可能性是仅有轻度或无白质病变患者（最低五分位数）的3 - 5倍（心室周围比值比[or] = 3.3； 95%可信区间[CI]， 1.2-9.5；皮质下比值比[or] =5.4; 95% CI, 1.8-16.5）。此外，与仅有轻度或无白质病变的患者相比，有严重皮质下白质病变而非脑室周围白质病变的患者更有可能在60岁后出现抑郁症病史（OR=3.4; 95% CI, 1.1-10.7）。结论：皮质下白质病变的严重程度与抑郁症状的存在和迟发性抑郁史有关。
Background: There is evidence for a vascular cause of late-life depression. Cerebral white matter lesions are thought to represent vascular abnormalities. White matter lesions have been related to affective disorders and a history of late-onset depression in psychiatric patients. Their relation with mood disturbances in the general population is not known. We investigated the relation between white matter lesions and the presence of depressive symptoms or a history of depression in a population-based study.Methods: In a sample of 1077 nondemented elderly adults, we assessed the presence and severity of subcortical and periventricular white matter lesions using magnetic resonance imaging, presence of depressive symptoms, and history of depression. Using multiple regression analysis, we examined the relation among white matter lesions, depressive symptoms, and history of depression.Results: Most of the subjects had white matter lesions. Persons with severe white matter lesions (upper quintile) were 3 to 5 times more likely to have depressive symptoms as compared with persons with only mild or no white matter lesions (lowest quintile) (periventricular odds ratio [OR] = 3.3; 95% confidence interval [CI], 1.2-9.5; subcortical OR=5.4; 95% CI, 1.8-16.5). In addition, persons with severe subcortical but not periventricular white matter lesions were more likely to have had a history of depression with an onset after age 60 years (OR=3.4; 95% CI, 1.1-10.7) compared with persons with only mild or no white matter lesions.Conclusion: The severity of subcortical white matter lesions is related to the presence of depressive symptoms and to a history of late-onset depression.