The prevalence of depression in relation to cerebral atrophy and cognitiveperformance in 70- and 74-year-old women in Gothenburg. The Women's HealthStudy

Background. Hospital-based studies report that depression in the elderly is associated with brain atrophy. This notion could not be confirmed in a pop ulation study on 85-year-olds. We aimed to assess depression in relation to brain atrophy and cognition in 70- and 74-year-old women. Methods. A representative sample of 70- and 74-year-old women (N = 501) was examined with a psychiatric examination including the Mini-Mental State Ex amination (MMSE), measuring global cognitive function, and computerized tom ography (CT) of the brain (N = 268). Depression was diagnosed according to DSM-III-R. Previous depression was diagnosed by history and by information from previous examinations in this 24-year longitudinal study. Results. The prevalence of depression was 11.6 %, including 8.4 % with majo r depression (MDD). Among those who were currently mentally healthy, 43.0% had a history of previous depression. Women with current MDD had lower scor es on the MMSE than the mentally healthy women. This association was only f ound in women with a lower level of education. Current depressives, previou s depressives and mentally healthy women without a history of depression di d not differ on CT with regard to brain atrophy or white matter lesions. Th e association between MDD and lower cognitive performance was independent o f the association of cognitive performance with structural brain changes on CT. Conclusions. Brain atrophy on CT is not associated with depression in the g eneral population, despite the fact that individuals with depression have a worse cognitive performance. The finding that cognitive performance was no t decreased in individuals with previous depression suggests that cognitive dysfunction is a state phenomenon in depression.