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Vascular Brain Disease and Depression in the Elderly

Ikram, M Arfana; Luijendijk, Hendrika J.a,b; Vernooij, Meike W.a,c; Hofman, Alberta; Niessen, Wiro J.c,d,e; van der Lugt, Aadc; Tiemeier, Henninga; Breteler, Monique M. B.a

doi: 10.1097/EDE.0b013e3181c1fa0d
Mental Illness: Brief Report

Background: Cross-sectional studies have shown an association between vascular brain disease and depression. Longitudinal data are scarce. In a population-based study we investigated this relationship both cross-sectionally and longitudinally.

Methods: Brain MRIs were administered to 479 persons aged 60–90 years at baseline (1995–1996). Brain atrophy, white matter lesions and brain infarcts are all markers of vascular brain disease. At baseline and at follow-up examinations, we also identified persons with depressive symptoms and syndromes using the Center for Epidemiological Studies Depression Scale and psychiatric interviews. Medical records were continuously monitored to identify incident depression. Follow-up was complete until October 2005.

Results: At baseline, 36 persons had depressive symptoms. Brain atrophy, white matter lesions, and infarcts were associated with presence of depressive symptoms. During follow-up, 92 persons developed depressive symptoms, 35 of whom were categorized as having depressive syndrome. There was no association of any MRI marker with incident depressive symptoms or syndromes.

Conclusions: Markers of vascular brain disease were associated with depression cross-sectionally. However, when these markers and risk of depression were assessed longitudinally, no relationship was found.


From the aDepartment of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; bDepartment of Geriatric Psychiatry, Parnassia BAVO Group, Institution for Mental Health Care, Rotterdam, The Netherlands; Departments of cRadiology and dMedical Informatics, Erasmus MC University Medical Center, Rotterdam, The Netherlands; and eDepartment of Applied Sciences, Delft University of Technology, Delft, The Netherlands.

Submitted 10 October 2008; accepted 20 March 2009.

The Rotterdam Scan Study was financially supported by the Health Research and Development Council and the Netherlands Organization for Scientific Research (grants 918–46–615, 904–61–096, 904–61–133).

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Correspondence: Monique M. B. Breteler, Department of Epidemiology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. E-mail:

© 2010 Lippincott Williams & Wilkins, Inc.