Cerebrovascular disease and depression symptoms in the Cardiovascular Health Study

Background and Purpose-Evidence is mounting linking cerebrovascular disease with depressive symptoms in the elderly. Lesions in both white and gray ma tter have been associated with depressive symptoms and major depression. We sought to investigate the relationship between depressive symptoms and whi te and gray matter lesions in subjects participating in the Cardiovascular Health Study. Methods-In a sample of 3660 men and women who underwent a standardized inte rview, physical examination, and MRI scan, we examined the association betw een number of white and gray matter lesions and white matter grade (a measu re of severity) and reported depressive symptoms using a modified version o f the Centers fur Epidemiologic Studies Depression (CES-D) scale. We contro lled for a variety of demographic and medical variables as well as function al status and Modified Mini-Mental State Examination score. Results-The number of small (<3 mm) basal ganglia lesions was significantly associated with reported depressive symptoms, but white matter grade was n ot. In subsequent logistic regression models, number of basal ganglia lesio ns remained a significant predictor after controlling for non-MRI variables and severity of white matter lesions. Conclusions-Our findings extend previous reports that linked cerebrovascula r changes to depressive symptoms in clinical populations to a large communi ty-based population. This report provides further evidence of the importanc e of basal ganglia lesions in geriatric depression.