Clinical and neuroradiologic features associated with chronicity in late-life depression

The authors conducted a 6-year follow-up of 16 patients with late-life depr ession to evaluate the relationships between clinical and neuroradiologic v ariables and disease outcome. Patients had a comprehensive neuropsychiatric evaluation and magnetic resonance imaging (MRI) at baseline and follow-up. Eight of the IG developed a chronic course of unremitting major depression sufficient to cause significant psychosocial impairment. Six patients with a chronic course and four patients with a non-chronic course of depression had white matter hyperintensities (WMH) on MRI at baseline. Four patients whose WMH increased in size over time developed a chronic unremitting cours e of depression. No patients with non-chronic depression had large areas of WMH at baseline or exhibited increased WMH size over time. Chronic depress ion was associated with severity of cerebrovascular risk factors, apathy, a nd poor quality, of life. Treatment and prevention of cerebrovascular disea se may improve the outcome of late-life depression.