In:
International Journal of Geriatric Psychiatry, Wiley, Vol. 31, No. 1 ( 2016-01), p. 58-65
Abstract:
Cerebral small vessel disease (SVD) is associated with late‐onset depression and increases the risk for depression after stroke. We aimed to investigate baseline predictors of depression after long‐term follow‐up in patients with SVD, initially presenting with first‐ever lacunar stroke, free of depression and cognitive impairment. Methods A total of 294 patients with SVD were evaluated 3–5 years after the qualifying event. We analyzed baseline demographic data, vascular risk factors, functional status expressed as a score on modified Rankin Scale (mRS), cognitive status, presence of depression, total number of lacunar infarcts and severity of white matter hyperintensities (WMH) on MRI with Age‐Related White Matter Changes scale total score (tARWMC) and Fazekas scale periventricular and deep subcortical scores. Results On follow‐up, depression was registered in 117 (39.8%) SVD patients. At the baseline, patients with depression compared with non‐depressed were older (64.4 vs 60.9 years; p = 0.007), had higher mRS score (2.8 ± 0.7 vs 1.5 ± 0.7; p 〈 0.0001) and had more severe lesions on MRI scales ( p 〈 0.0001 for all parameters). On follow‐up, depressed patients more frequently exhibited cognitive decline (75.2% depressed vs 56.5% non‐depressed; p = 0.003). No difference was detected in risk factor frequency between groups. Multivariate Cox regression analysis adjusted by age and gender revealed independent predictors of depression: baseline mRS 〉 2 (HR 2.17, 95%CI 1.74–2.72; p 〈 0.0001) and tARWMC (HR 1.05, 95%CI 1.02–1.09; p = 0.005), and cognitive decline on follow‐up (HR 1.80, 95%CI 1.12–2.89; p = 0.015). Conclusions Baseline functional status and severity of WMH and development of cognitive decline predict the occurence of late‐onset depression in patients with SVD. Copyright © 2015 John Wiley & Sons, Ltd.
Type of Medium:
Online Resource
ISSN:
0885-6230
,
1099-1166
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
1500455-7
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