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White Matter Lesions and Temporal Lobe Atrophy Related to incidence of both Dementia and Major Depression in 70-year-olds followed over 10 years

Journal article
Authors Pia Gudmundsson
Pernille J Olesen
Michela Simoni
Leonardo Pantoni
Svante Östling
Silke Kern
Xinxin Guo
Ingmar Skoog
Published in European Journal of Neurology
Volume 22
Issue 5
Pages 781–788
ISSN 1351-5101
Publication year 2015
Published at Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Pages 781–788
Language en
Keywords depression, dementia, white matter lesions, temporal lobe atrophy, longitudinal, computed tomography
Subject categories Neurosciences, Other Medical Sciences


Abstract Background: A number of studies have suggested associations between dementia and depression in older adults. One reason could be that these disorders share structural correlates, such as white matter lesions (WMLs) and cortical atrophy. No study has examined whether these lesions precede both dementia and depression independently of each other in the general population. Methods: We investigated whether WMLs and cortical atrophy on computed tomography (CT) predict dementia and depression in a population-based sample of 70-year-olds (n=380) followed over 10 years. Exclusion criteria were dementia, major depression, history of stroke and a Mini-Mental State Examination score below 26 at baseline in 2000-01. Dementia was diagnosed according to DSM-III-R and depression according to DSM-5. Primary outcomes included dementia and major depression at 10-year follow-up. Results: Adjusted logistic regression models, including both WMLs and temporal lobe atrophy, showed that moderate-to-severe WMLs (OR 3.96, 95% CI 1.23-12.76) and temporal lobe atrophy (OR 2.93, 95% CI 1.13-7.60) predicted dementia during 10-year follow-up independently of major depression. Similarly, both moderate-to-severe WMLs (OR 3.84, 95% CI 1.25-11.76) and temporal lobe atrophy (OR 2.52, 95% CI 1.06-5.96) predicted depression even after controlling for incident dementia. Conclusion: WMLs and temporal lobe atrophy preceded 10-year incidence of both dementia and depression in 70-year-olds. Shared structural correlates could explain the reported associations between dementia and depression. These brain changes may represent independent and complementary pathways to dementia and depression. Strategies to slow progression of vascular pathology and neurodegeneration could indirectly prevent both dementia and depression in older adults.

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