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Cerebrovascular disease and evolution of depressive symptoms in the cardiovascular health study.

TitleCerebrovascular disease and evolution of depressive symptoms in the cardiovascular health study.
Publication TypeJournal Article
Year of Publication2002
AuthorsSteffens, DC, K Krishnan, RRama, Crump, C, Burke, GL
JournalStroke
Volume33
Issue6
Pagination1636-44
Date Published2002 Jun
ISSN1524-4628
KeywordsAged, Aged, 80 and over, Basal Ganglia Cerebrovascular Disease, Brain, Cerebrovascular Disorders, Cohort Studies, Comorbidity, Depression, Disease Progression, Female, Health Surveys, Humans, Incidence, Logistic Models, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Odds Ratio, United States
Abstract<p><b>BACKGROUND AND PURPOSE: </b>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.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p>
DOI10.1161/01.str.0000018405.59799.d5
Alternate JournalStroke
PubMed ID12053004
Grant ListK07 MH01367 / MH / NIMH NIH HHS / United States
N01-HC-85079 / HC / NHLBI NIH HHS / United States
N01-HC-85086 / HC / NHLBI NIH HHS / United States
P50 MH60451 / MH / NIMH NIH HHS / United States