The Study of White Matter Hyperintensity (WMH) and Factors Related to Geriatric Late-Onset Depression

Shanghai Arch Psychiatry. 2018 Feb 25;30(1):12-19. doi: 10.11919/j.issn.1002-0829.217038.

Abstract

Background: Geriatric depression is one of the most common and harmful mental illnesses seen in the elderly. However, there are few studies focusing on the relationship between late-onset depression (LOD) and social and psychological factors, as well as brain structure.

Aims: To explore factors related to late-onset depression (LOD) in elderly patients.

Methods: 24 first onset LOD patients over 60 years old (meeting ICD-10 diagnostic criteria for depression) and 23 non-depressed elders were selected for inclusion into this study. Scale assessments, including Fazelasscale for white matter hyperintensity (WMH) high signal level and the MTA-scale for medial temporal lobe atrophy levels, were combined with general demography and sociology data to find factors related to LOD.

Results: There was no significant difference in age (t=0.419, p=0.678), gender (X2=1.705, p=0.244), or years of education (t=1.478, p=0.146) between the two groups. However, statistical differences were shown on scores on the WMH, (X2=7.817, p=0.008), periventricular white matter hyperintensity (PWMH)(Fisher exact test: p=0.031), having or not having religious beliefs (Fisher exact test: p=0.265) and family harmony (yes or no) (Fisher exact test: p=0.253) between the LOD group and control group. The results of linear regression analysis showed that the total score for WMH, religious beliefs (with or without) and family harmony (yes or no) were associated with depressive symptomology.

Conclusion: Scores on the WMH, religious beliefs and family harmony are all potentially related to LOD in elderly patients.

背景: 老年抑郁症是老年人常见且危害性大的精神疾 病之一,但目前对晚发型老年抑郁症与之相关的社会、 心理学及脑结构因素之间的联系的研究较少。.

目的: 探讨晚发型老年抑郁症(LOD)的相关因素。.

方法: 共纳入24 例首次发病年龄大于60 岁的晚发型 老年抑郁症患者(诊断符合ICD-10 抑郁症的诊断标准) 和23 例健康老人作为研究的对象。通过视觉评估量表: Fazekas 量表评估脑白质高信号的严重程度,MTA 量表 评估内侧颞叶萎缩程度,结合一般人口学资料及社会 学资料,寻找晚发型老年抑郁症的影响因素。.

结果: 两组间的年龄(t=0.419, p=0.678)、性别(X2=1.705, p=0.244)、教育程度(t=1.478, p=0.146) 均无统计学差异。 两组人群在脑白质高信号评分(WMH)、脑室旁高信号 评分(PWMH)、宗教信仰(有或无)和家庭和睦(是 或否)亚项上存在差异(X2=7.817, p=0.008;Fisher 精 确检验:p=0.031;Fisher 精确检验:p=0.265;Fisher 精确检验:p=0.253),而逐步线性回归的结果显示, 脑白质高信号评分、宗教信仰(有或无)和家庭和睦(是 或否)是老年抑郁的相关因素。.

结论: 脑白质高信号是晚发型老年抑郁症的风险因素, 而具有宗教信仰和/ 或家庭和睦是其保护性因素。.

Keywords: Family harmony; Geriatric depression; Late onset; MRI; Religious belief; White matter hyperintensity.