American Journal of Epidemiology Vol. 150, No. 9: 919-929
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health
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Neuroanatomic and Functional Correlates of Depressed Mood: The Cardiovascular Health Study
1Department of Epidemiology, The Johns Hopkins University School of Hygiene and Public Health Baltimore, MD
2Division of Neuroradiology, The Johns Hopkins Medical Institutions Baltimore, MD
3Department of Medicine, Welch Center for Prevention, Epidemiology, and Clinical Research, The Johns Hopkins Medical Institutions Baltimore, MD
Reprint requests to Dr. Linda P. Fried, Departments of Medicine and Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 East Monument Street, Suite 2-600, Baltimore, MD 21205-2223.
Although a number of studies suggest an association between stroke and depression, few have examined the relation between magnetic resonance imaging (MRI)-identified lesions and depression among community-dwelling older adults. This cross-sectional study sought to assess the association between MRI infarcts in the basal ganglia and non-basal-ganglia areas, potential functional consequences of these lesions, and depressive symptomatology in 3,371 US men and women aged 65 years or older who participated in the Cardiovascular Health Study between 1992 and 1994. By using multiple linear regression models, the authors found that after adjustment for age, gender, and stroke history, Center for Epidemiologic Studies Depression Scale scores were independently associated with non-basal-ganglia lesions (p = 0.04) but were not independently associated with basal ganglia lesions (p = 0.11). When measures of physical disability and cognitive impairment were added to the models, these measures displaced MRI-identified infarcts in their association with depressive symptoms. In additional models, hemispheric location and size of the basal ganglia lesion were found to have no relation to depression levels. These results suggest that the functional consequences of cerebrovascular disease may be the causal pathway by which basal ganglia and non-basal-ganglia lesions are associated with depressive symptomatology. Am J Epidemiol 1999;150:919-29.
aged; cerebral infarction; cerebrovascular disorders; depression; magnetic resonance imaging
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