Background: Several studies have reported smaller hippocampal volume (HcV) in depression patients; however, the temporality of the association remains unknown. One proposed hypothesis is that depression may cause HcV loss. This study evaluates whether previous depression and recent depressive symptoms are associated with HcV and HcV loss.Method: We used a prospective cohort of older adults (n= 1328; age = 65–80 years) with two cerebral magnetic resonance imaging examinations at baseline and 4-year follow-up. Using multivariable linear regression models, we estimated, in stratified analyses by gender, the association between indicators of history of depression and its severity (age at onset, recurrence, hospitalization for depression), proximal depressive symptoms [Center for Epidemiologic Studies-Depression (CES-D) scale], baseline antidepressant use, and the outcomes: baseline HcV and annual percentage change in HcV.Results: At baseline, women with more depressive symptoms had smaller HcV [−0.05 cm³, 95% confidence interval (CI) −0.1 to −0.01 cm³per 10-unit increase in CES-D scores]. History of depression was associated with a 0.2% faster annual HcV loss in women (95% CI 0.01–0.36%). More baseline depressive symptoms and worsening of these symptoms were also associated with accelerated HcV loss in women. No associations were observed in men. Treatment for depression was associated with slower HcV loss in women and men.Conclusions: While only concomitant depressive symptoms were associated with HcV, both previous depression and more proximal depressive symptoms were associated with faster HcV loss in women.

The authors' objective was to investigate the associations of body mass index (BMI; weight (kg)/height (m)²) and blood pressure with the risk of developing depression in a large sample of elderly French participants (aged ≥65 years) followed for 10 years (Dijon portion of the Three-City Study, 1999–2010). Depression was defined as either having major depressive symptoms according to the Mini-International Neuropsychiatric Interview or taking antidepressant medication. The authors fitted marginal structural models to examine the relations of BMI and blood pressure with depression. Among subjects who were depression-free at baseline (n = 3,090), 478 developed incident depression over 10 years of follow-up. The analyses showed that after baseline values and time-dependent confounders were controlled, subjects with high BMI at follow-up had an increased adjusted risk of developing depression compared with subjects with normal BMI (risk ratio = 1.60, 95% confidence interval: 1.03, 2.51). Compared with subjects with normal blood pressure, those with high blood pressure were not at increased risk of incident depression, whereas those with low blood pressure had a higher risk of developing depression. These findings provide some epidemiologic support for implication of lifestyle risk factors in the development of depression in the elderly. Future studies should focus on evaluating lifestyle and obesity interventions among the elderly.

Objective: Low socioeconomic position (SEP) has been linked to an increased risk of dementia and cognitive decline. However, little is known about the association between SEP and morphologic brain changes in older age. This study examines the relationships between indicators of life-course SEP with both hippocampal volume (HcV) and HcV loss in a population-based cohort of 1328 older adults aged 65 to 80 years. Methods: Multivariable linear regression models were used to estimate the associations of SEP with baseline HcV and the annual rate of HcV atrophy according to three life-course conceptual models: the sensitive/critical periods model (which explored SEP in specific periods: in childhood [using parental education], early adulthood [based on participants' education], and midlife [based on participants' socioprofessional group]); the accumulation-of-risk model (life-course cumulative SEP), and the social mobility model (life-course SEP trajectories). Results: Participants with lower midlife SEP had smaller HcV (−0.08 cm³; 95% confidence interval, −0.15 to −0.01) and 0.17% (95% confidence interval, 0.04%–0.30%) faster hippocampal atrophy than participants with higher midlife SEP. Childhood and early adulthood SEPs were not related to hippocampal measures. The accumulation-of-risk and the social mobility models revealed that the accumulation of socioeconomic disadvantage and declining socioeconomic trajectories were related to faster hippocampal atrophy. Conclusions: In this cohort of older adults, lower socioprofessional attainment in midlife and disadvantageous life-course socioeconomic position were associated with faster hippocampal atrophy, a cerebral change linked to cognitive disorders. Results support the hypothesized links between socioenvironmental exposures related to stress and/or cognitive enrichment and brain/cognitive reserve capacities.

Several studies have reported smaller hippocampal volume in patients with depression. However, the temporality of the association is undetermined. One hypothesis is that hippocampal atrophy might be a susceptibility factor for depression. In the present study, we assessed whether hippocampal atrophy was associated with subsequent depressive symptoms in a cohort of older French adults (n = 1,309) who were 65–80 years of age and enrolled into the study in 1999–2001 in Dijon, France. Subjects were followed for more than 10 years. Participants underwent 2 cerebral magnetic resonance imaging scans, one at baseline and one at the 4-year follow-up. We used linear mixed models to estimate the associations of hippocampal atrophy with 1) the average depressive symptom scores over follow-up (using the Center for Epidemiologic Studies-Depression scale) measured biennially over the subsequent 6 years and 2) changes in symptom scores over follow-up. In women, a 2-standard-deviation increase in annual hippocampal atrophy was associated with a 1.67-point (95% confidence interval: 0.59, 2.77) increase in the average depressive symptom score over follow-up and with a 1.97-point (95% confidence interval: 0.68, 3.24) increase in scores over the 2 subsequent years but not with later changes in symptoms. No association was detected in men. Accounting for potential selective attrition (using inverse probability weights) did not alter results. Hippocampal atrophy was associated with more subsequent depressive symptoms and with shorter-term worsening of symptoms in women.