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. 2014 Dec;22(12):1504-12.
doi: 10.1016/j.jagp.2013.11.004. Epub 2013 Nov 22.

Hippocampus atrophy and the longitudinal course of late-life depression

Warren D Taylor  1 , Douglas R McQuoid  2 , Martha E Payne  2 , Anthony S Zannas  2 , James R MacFall  3 , David C Steffens  4
Affiliations

Hippocampus atrophy and the longitudinal course of late-life depression

Warren D Taylor et al. Am J Geriatr Psychiatry. 2014 Dec.

Abstract

Objectives: Smaller hippocampal volumes are observed in depression but it remains unclear how antidepressant response and persistent depression relate to changes in hippocampal volume. We examined the longitudinal relationship between hippocampal atrophy and course of late-life depression.

Setting: Academic medical center.

Participants: Depressed and never-depressed cognitively intact subjects age 60 years or older.

Measurements: Depression severity was measured every three months with the Montgomery-Asberg Depression Rating Scale (MADRS). Participants also completed cranial 1.5-T magnetic resonance imaging every 2 years. We compared 2-year change in hippocampal volume based on remission status, then in expanded analyses examined how hippocampal volumes predicted MADRS score.

Results: In analyses of 92 depressed and 70 never-depressed subjects, over 2 years the cohort whose depression never remitted exhibited greater hippocampal atrophy than the never-depressed cohort. In expanded analyses of a broader sample of 152 depressed elders, depression severity was significantly predicted by a hippocampus × time interaction where smaller hippocampus volumes over time were associated with greater depression severity.

Conclusions: Hippocampal atrophy is associated with greater and persistent depression severity. Neuropathological studies are needed to determine if this atrophy is related to the toxic effects of persistent depression or related to underlying Alzheimer disease.

Keywords: Geriatrics; MRI; depression; hippocampus; longitudinal; neuroimaging.

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Conflict of interest statement

The authors report no financial conflicts of interest.

Figures

Figure 1
Figure 1
Two-year change in proportional hippocampus volumes Total hippocampal volumes at baseline and year two. Presented are adjusted means for each time point, controlling for age and baseline cerebral volume. After controlling for these covariates in addition to time and hemisphere, hippocampal volume change differed significantly between cohorts (Table 3). This was primarily related to differences between the nonremitted and never-depressed cohorts. Other cohort comparisons did not demonstrate statistically significant differences.
See this image and copyright information in PMC

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