Skip to main content
Journal cover image

Subcortical white matter lesions and functional impairment in geriatric depression.

Publication ,  Journal Article
Steffens, DC; Bosworth, HB; Provenzale, JM; MacFall, JR
Published in: Depress Anxiety
2002

Geriatric depression is associated with significant functional impairment. There is also growing evidence linking vascular brain changes to depression in late life. We sought to examine the relationship between cerebrovascular disease and impairment in basic activities of daily living (BADL) and instrumental activities of daily living (IADL) in a group of older depressives. The sample consisted of 224 depressed adults aged 60 years and above enrolled in Duke's Mental Health Clinical Research Center. All subjects had unipolar major depression and were free of other major psychiatric and neurological illness, including dementia. In a structured interview, subjects reported their medical history and ability to perform both BADL and IADL. Geriatric psychiatrists assessed cognition using the Mini Mental State Examination (MMSE) and depression severity using the Montgomery Asberg Depression Rating Scale (MADRS). Subjects had a standardized magnetic resonance imaging (MRI) brain scan. MRI scans were processed using a semi-automated method to determine volumes of subcortical white matter lesions (WML) and subcortical gray matter lesions (GML). Logistic regression was used to examine effects of WML and GML controlling for demographic and clinical factors. Greater volume of WML was associated with impairment in both BADL and IADL, while GML was associated with IADL impairment. In logistic models, WML remained significantly associated with IADL after controlling for the effects of age, gender, depression severity, and medical comorbidity. We concluded that white matter lesions are independently associated with functional impairment. Further studies are needed to understand how these lesions affect function, e.g., through effects on cognition or motor skills.

Duke Scholars

Published In

Depress Anxiety

DOI

ISSN

1091-4269

Publication Date

2002

Volume

15

Issue

1

Start / End Page

23 / 28

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Psychomotor Disorders
  • Psychiatry
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Female
  • Depressive Disorder, Major
  • Cognition Disorders
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Steffens, D. C., Bosworth, H. B., Provenzale, J. M., & MacFall, J. R. (2002). Subcortical white matter lesions and functional impairment in geriatric depression. Depress Anxiety, 15(1), 23–28. https://doi.org/10.1002/da.1081
Steffens, David C., Hayden B. Bosworth, James M. Provenzale, and James R. MacFall. “Subcortical white matter lesions and functional impairment in geriatric depression.Depress Anxiety 15, no. 1 (2002): 23–28. https://doi.org/10.1002/da.1081.
Steffens DC, Bosworth HB, Provenzale JM, MacFall JR. Subcortical white matter lesions and functional impairment in geriatric depression. Depress Anxiety. 2002;15(1):23–8.
Steffens, David C., et al. “Subcortical white matter lesions and functional impairment in geriatric depression.Depress Anxiety, vol. 15, no. 1, 2002, pp. 23–28. Pubmed, doi:10.1002/da.1081.
Steffens DC, Bosworth HB, Provenzale JM, MacFall JR. Subcortical white matter lesions and functional impairment in geriatric depression. Depress Anxiety. 2002;15(1):23–28.
Journal cover image

Published In

Depress Anxiety

DOI

ISSN

1091-4269

Publication Date

2002

Volume

15

Issue

1

Start / End Page

23 / 28

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Psychomotor Disorders
  • Psychiatry
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Female
  • Depressive Disorder, Major
  • Cognition Disorders