Association of white matter hyperintensities and clinical vascular burden with depressive symptoms in Black older adults

• Published in: International journal of geriatric psychiatry 2024-01, Vol.39 (1), p.e6052-n/a
• Main Authors: Bogoian, Hannah R., Barber, Sarah J., Carter, Sierra E., Mingo, Chivon, Rosano, Caterina, Dotson, Vonetta M.
• Format: Article
• Language: English
• Subjects: African American; Aged; Aging; Body composition; Brain - diagnostic imaging; Depression - diagnosis; Epidemiology; Geriatric psychiatry; Humans; Magnetic Resonance Imaging; Mental depression; Older people; race differences; Substantia alba; subthreshold depression; vascular depression; White Matter - diagnostic imaging; white matter lesions
• ISSN: 0885-6230; 1099-1166; 1099-1166
• DOI: 10.1002/gps.6052

Objectives Black older adults have a higher vascular burden compared to non‐Hispanic White (NHW) older adults, which may put them at risk for a form of depression known as vascular depression (VaDep). The literature examining VaDep in Black older adults is sparse. The current study addressed this important gap by examining whether vascular burden was associated with depressive symptoms in Black older adults. Methods Participants included 113 Black older adults from the Healthy Brain Project, a substudy of the Health, Aging, and Body Composition Study. In multiple regression analyses, clinical vascular burden (sum of vascular conditions) and white matter hyperintensity (WMH) volume predicted depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale, controlling for demographic variables. Follow‐up analyses compared the associations in the Black subsample and in 179 NHW older adults. Results Higher total WMH volume, but not clinically‐defined vascular burden, predicted higher concurrent depressive symptoms and higher average depressive symptoms over 4 years. Similar associations were found between uncinate fasciculus (UF) WMHs and concurrent depressive symptoms and between superior longitudinal fasciculus WMHs and average depressive symptoms. The association between depressive symptoms and UF WMH was stronger in Black compared to NHW individuals. Conclusion This research is consistent with the VaDep hypothesis and extends it to Black older adults, a group that has historically been underrepresented in the literature. Results highlight WMH in the UF as particularly relevant to depressive symptoms in Black older adults and suggest this group may be particularly vulnerable to the negative effects of WMH. Key points Total, uncinate fasciculus (UF), and superior longitudinal fasciculus white matter hyperintensities were associated with higher depressive symptoms in Black older adults, but clinically‐defined vascular burden was not. The relationship between UF white matter hyperintensity burden and depressive symptoms was stronger in Black than in White individuals. Findings are consistent with the VaDep framework and extend it to an older Black sample.