Depressive Symptoms, Antidepressant Use, and Brain Volumes on MRI in a Population-Based Cohort of Old Persons without Dementia

Article type: Research Article

Authors: Geerlings, Mirjam I.^a | Brickman, Adam M.^{b; c; d} | Schupf, Nicole^{b; d; e; f} | Devanand, Davangere P.^{b; f} | Luchsinger, José A.^{b; c; e; g} | Mayeux, Richard^{b; c; d; e; f} | Small, Scott A.^{b; c; d; *}

Affiliations: [a] University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands | [b] Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA | [c] Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA | [d] Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA | [e] Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, USA | [f] Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA | [g] Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA

Correspondence: [*] Correspondence to: Scott A. Small, MD, Columbia University, School of Physicians and Surgeons, 630 West 168th Street, PH #19, New York, NY, 10032, USA. Tel.: +1 212 305 1269; E-mails: [email protected] and [email protected].

Abstract: We examined whether late-life depression, including depressive symptoms and antidepressant use, was associated with smaller total brain volume, smaller hippocampal volume, and larger white matter hyperintensity (WMH) volume in a large community-based cohort of old persons without dementia. Within the Washington/Hamilton Height-Inwood Columbia Aging Project (WHICAP), a community-based cohort study in northern Manhattan, 630 persons without dementia (mean age 80 years, SD = 5) had volumetric measures of the total brain, hippocampus, and WMH at 1.5 Tesla MRI and data on current depression, defined as a score of 4 or higher on the 10-item Center for Epidemiologic Studies-Depression (CES-D) scale, or use of antidepressants. Multiple linear regression analyses adjusted for age, gender, ethnicity, education, cardiovascular disease history, and MRI parameters showed that subjects with current depression had smaller relative total brain volume (B = −0.86%; 95% CI −1.68 to −0.05%; p < 0.05), smaller relative hippocampal volume (B = −0.07 ml; 95% CI −0.14 to 0.00 ml; p = 0.05), and larger relative WMH volume (natural logtransformed B = 0.19 ml; 95% CI 0.02 to 0.35 ml; p < 0.05). When examined separately, antidepressant use was significantly associated with smaller total brain, smaller hippocampal, and larger WMH volume, while high CES-D scores were not significantly associated with any of the brain measures, although the direction of association was similar as for antidepressant use. With the caveat that analyses were cross-sectional and we had no formal diagnosis of depression, our findings suggest that in this community-based sample of old persons without dementia, late-life depression is associated with more brain atrophy and more white matter lesions, which was mainly driven by antidepressant use.

Keywords: Antidepressants, brain, cohort, depressive symptoms, elderly, hippocampus, MRI, population-based, white matter hyperintensity

DOI: 10.3233/JAD-2012-112009

Journal: Journal of Alzheimer's Disease, vol. 30, no. 1, pp. 75-82, 2012