Neuropathology of depression in non-demented older adults: A large postmortem study of 741 individuals

Associations between age-related neuropathological lesions and adult-onset lifetime major depressive disorder (a-MDD), late-life MDD (LLD), or depressive symptoms close to death (DS) were examined in a large community sample of non-demented older adults. Seven hundred forty-one individuals (age at d...

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Published in:Neurobiology of aging 2022-09, Vol.117, p.107-116
Main Authors: Nunes, Paula Villela, Suemoto, Claudia Kimie, Rodriguez, Roberta Diehl, Paraizo Leite, Renata Elaine, Nascimento, Camila, Pasqualucci, Carlos Augusto, Nitrini, Ricardo, Jacob-Filho, Wilson, Grinberg, Lea T., Lafer, Beny
Format: Article
Language:English
Subjects:
Aged
Alzheimer
Alzheimer Disease - pathology
Brain - pathology
Dementia - pathology
Depression
Depressive Disorder, Major - pathology
Humans
Lewy
Lewy Bodies - pathology
Lewy Body Disease - pathology
Older adults
Plaque, Amyloid - pathology
Post-mortem
Vascular
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Summary:Associations between age-related neuropathological lesions and adult-onset lifetime major depressive disorder (a-MDD), late-life MDD (LLD), or depressive symptoms close to death (DS) were examined in a large community sample of non-demented older adults. Seven hundred forty-one individuals (age at death = 72.2 ± 11.7 years) from the Biobank for Aging Studies were analyzed. a-MDD was present in 54 (7.3%) participants, LLD in 80 (10.8%), and DS in 168 (22.7%). After adjustment for covariates and compared to controls, a-MDD, LDD and DS were associated with small vessel disease (p = 0.039, p = 0.003, and p = 0.003 respectively); LLD, and DS were associated with brain infarcts (p = 0.012, p = 0.018, respectively) and Lewy body disease (p = 0.043, p = 0.002, respectively). DS was associated with beta-amyloid plaque burden (p = 0.027) and cerebral amyloid angiopathy (p = 0.035) in cognitively normal individuals (Clinical Dementia Rating scale = 0). Vascular brain pathology was the strongest correlate of clinical depictions of depression in the absence of dementia, corroborating the vascular hypothesis of depression. Lewy body pathology underlay DS. An older adult with DS or LLD should be monitored for possible cognitive decline or neurodegenerative disorders.
ISSN:0197-4580
1558-1497
DOI:10.1016/j.neurobiolaging.2022.05.007