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Depression, cerebral atrophy, cognitive performance and incidence of dementia

Population study of 85-year-olds

Published online by Cambridge University Press:  02 January 2018

Sigurdur Pálsson*
Affiliation:
Institute of Clinical Neuroscience, Department of Psychiatry, Sahlgrenska University Hospital, S-413 45, Göteborg, Sweden
Ólafur Aevarsson
Affiliation:
Institute of Clinical Neuroscience, Department of Psychiatry, Sahlgrenska University Hospital, S-413 45, Göteborg, Sweden
Ingmar Skoog
Affiliation:
Institute of Clinical Neuroscience, Department of Psychiatry, Sahlgrenska University Hospital, S-413 45, Göteborg, Sweden
*
Sigurdur Pálsson, MD, Department of Psychiatry, The University Hospital, Landspitalinn, PO Box 10, 121 Reykjavík, Iceland. Tel: +354 56 01 000 or +354 564 560 1718; Fax: +354 56 01 720; e-mail: sigpp@rsp.is

Abstract

Background

Hospital-based studies suggest that depression in old age relates to organic brain changes.

Aims

To determine whether these findings are confirmed in a population-based sample.

Method

A population sample of non-demented 85-year-olds (227 mentally healthy and 62 with DSM–III–R depression were given a neuropsychiatric examination and computerised tomographic scans of the brain, and followed for three years.

Results

On the Mini-Mental State Examination, those with a low educational level with major depression performed worse than the mentally healthy; this distinction was not evident among those who had received higher education. Measures of brain atrophy were similar in depressed and mentally healthy individuals. The three-year incidence of dementia was increased in those with early-onset major depression.

Conclusions

Higher education may protect against cognitive symptoms in depressed individuals. The association between depression and cerebral atrophy in the elderly is not very strong. The higher incidence of dementia in those with early-onset major depression may be due to a longer lifetime duration of depression, emphasising the importance of detecting and treating depression in the community.

Type
Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

No commercial interest. Grants detailed in Acknowledgements.

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