MRI subcortical hyperintensities in old and very old depressed outpatients: The important role of age in late-life depression

Objective: There is increasing evidence that cerebrovascular factors play a key role in the etiology of late-life depression. This study examined the severity of subcortical hyperintensities (SH) and the relationship between SH and depression characteristics in two samples of elderly depressed outpatients differing in age. Methods: The samples consisted of 59 subjects age 60 and over, (69 +/- 5.6 years), who participated in a trial of sertraline, and 111 subjects age 75 and over, (79 +/- 4.1 years), who participated in a trial of citalopram. Results: The citalopram group was significantly older than the sertraline group and had more severe SH (72% vs. 42% high ratings). The High SH group was significantly older than the Low SH group in the sertraline study but there was no difference in age in the SH groups in the citaloprarn sample. There was no relationship between SH severity and baseline depression or age of onset. However, age strongly correlated with later age of onset. There was no relationship between SH severity and cardiovascular risk factors or treatment response in the sertraline sample. Conclusion: Age is a major factor for the development of SH and late-life depression. There may not be an association between SH and depression severity, cardiovascular risk factors, or treatment response in geriatric depressed outpatients. The etiologic factors and clinical course of late-life depression requires further study. (C) 2002 Elsevier Science B.V All rights reserved.