Cerebral white matter lesions and depressive symptoms in elderly adults

Background: There is evidence for a vascular cause of late-life depression. Cerebral white matter lesions are thought to represent vascular abnormalit ies. White matter lesions have been related to affective disorders and a hi story 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 sy mptoms or a history of depression in a population-based study. Methods: In a sample of 1077 nondemented elderly adults, we assessed the pr esence and severity of subcortical and periventricular white matter lesions using magnetic resonance imaging, presence of depressive symptoms, and his tory of depression. Using multiple regression analysis, we examined the rel ation among white matter lesions, depressive symptoms, and history of depre ssion. 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 hav e depressive symptoms as compared with persons with only mild or no white m atter 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 depressi on.