Abstract DP096: Associations of Late-life Depression with Neuroimaging Markers of Cerebrovascular and Neurodegenerative Disease

Objective: Epidemiological data have suggested that late-life depression (LLD) occurs as a consequence of cerebrovascular and neurodegenerative disorders, but there is also some evidence suggesting that the relationship may occur in the other direction, namely that LLD may be a risk factor for cerebrovascular and neurodegenerative disorders. However, the neurobiological basis of these associations remain unclear. This study investigated the associations of LLD with markers of cerebrovascular pathology, brain volumes, and cortical thickness from 3-Tesla brain magnetic resonance imaging (MRI). Methods: Participants from the Atherosclerosis Risk in Communities Study received brain MRI scans in late-life (ages 67-90). The following neuroimaging outcomes were assessed: cortical infarcts, lacunar infarcts, any microhemorrhages, lobar microhemorrhages, subcortical microhemorrhages, white matter hyperintensity volume, total and regional brain volumes (z-scores), and total average and regional cortical thickness (z-scores). At the same visit, LLD was evaluated with the 11-item Center for Epidemiological Studies Depression Scale (CES-D) and defined as CES-D score≥9. Associations between LLD and neuroimaging outcomes were examined using logistic and linear regression models, and were adjusted for age, race-center, sex, education level, vascular risk factors, stroke, cognitive status, APOE e4 carrier status, and total intracranial volume when assessing volumes. Results: Among 1,857 participants, the median age was 76 years, 59.5% were female, 28.3% were Black, and 6.8% had LLD. LLD was not associated with infarcts or microhemorrhages. There was no evidence of an association between LLD and total white matter hyperintensity volume or total average cortical thickness. However, LLD was independently associated with smaller volume (SD) of the rostral anterior cingulate (b 1 : -0.18; 95% CI: -0.33, -0.04) and greater cortical thickness (SD) in the medial orbitofrontal cortex (b 1 : 0.19; 95% CI: 0.01, 0.38), though effect sizes were small and did not survive correction for multiple comparisons. Conclusion: Findings from this study suggest LLD is not cross-sectionally associated with neuroimaging markers of cerebrovascular disease. While LLD may be linked to subtle volume and cortical thickness changes in specific regions of interest, future longitudinal research is warranted to validate and clarify these associations and explore their potentially bidirectional relationship.

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Journal
Stroke
Published
2026-01-29
DOI
https://doi.org/10.1161/str.57.suppl_1.dp096
Primary Topic
Cardiovascular Health and Risk Factors
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article
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article

Abstract DP096: Associations of Late-life Depression with Neuroimaging Markers of Cerebrovascular and Neurodegenerative Disease

Elizabeth Fracica, Sylee Kanetkar, Thomas Mosley, Clifford Jack et al.
Stroke
Cardiovascular Health and Risk Factors
article

Abstract DP096: Associations of Late-life Depression with Neuroimaging Markers of Cerebrovascular and Neurodegenerative Disease

Elizabeth Fracica, Sylee Kanetkar, Thomas Mosley, Clifford Jack, Myriam Fornage, Rebecca Gottesman, Valerie Morrill, David Knopman, Andrea Schneider
article en

Abstract

Objective: Epidemiological data have suggested that late-life depression (LLD) occurs as a consequence of cerebrovascular and neurodegenerative disorders, but there is also some evidence suggesting that the relationship may occur in the other direction, namely that LLD may be a risk factor for cerebrovascular and neurodegenerative disorders. However, the neurobiological basis of these associations remain unclear. This study investigated the associations of LLD with markers of cerebrovascular pathology, brain volumes, and cortical thickness from 3-Tesla brain magnetic resonance imaging (MRI). Methods: Participants from the Atherosclerosis Risk in Communities Study received brain MRI scans in late-life (ages 67-90). The following neuroimaging outcomes were assessed: cortical infarcts, lacunar infarcts, any microhemorrhages, lobar microhemorrhages, subcortical microhemorrhages, white matter hyperintensity volume, total and regional brain volumes (z-scores), and total average and regional cortical thickness (z-scores). At the same visit, LLD was evaluated with the 11-item Center for Epidemiological Studies Depression Scale (CES-D) and defined as CES-D score≥9. Associations between LLD and neuroimaging outcomes were examined using logistic and linear regression models, and were adjusted for age, race-center, sex, education level, vascular risk factors, stroke, cognitive status, APOE e4 carrier status, and total intracranial volume when assessing volumes. Results: Among 1,857 participants, the median age was 76 years, 59.5% were female, 28.3% were Black, and 6.8% had LLD. LLD was not associated with infarcts or microhemorrhages. There was no evidence of an association between LLD and total white matter hyperintensity volume or total average cortical thickness. However, LLD was independently associated with smaller volume (SD) of the rostral anterior cingulate (b 1 : -0.18; 95% CI: -0.33, -0.04) and greater cortical thickness (SD) in the medial orbitofrontal cortex (b 1 : 0.19; 95% CI: 0.01, 0.38), though effect sizes were small and did not survive correction for multiple comparisons. Conclusion: Findings from this study suggest LLD is not cross-sectionally associated with neuroimaging markers of cerebrovascular disease. While LLD may be linked to subtle volume and cortical thickness changes in specific regions of interest, future longitudinal research is warranted to validate and clarify these associations and explore their potentially bidirectional relationship.

StrokeVol. 57(Suppl_1)
National Institutes of Health (US), Mayo Clinic (US), Johns Hopkins University (US), University of Mississippi Medical Center (US), University of Pennsylvania (US), The University of Texas Health Science Center at Houston (US)
Good health and well-being
Openalex Percentile: Top 74%
Cardiovascular Health and Risk Factors
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