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Hippocampal Volume and Incident Dementia in Geriatric Depression

Received April 2, 2001; revised June 8, 2001; accepted July 9, 2001. From the Departments of Psychiatry and Behavioral Sciences, Community and Family Medicine, and Radiology, Duke University Medical Center, Durham, NC. Address correspondence to Dr. Steffens, Division of Geriatric Psychiatry, Box 3903, Duke University Medical Center, Durham, NC 27710. E-mail: steff001{at}mc.duke.edu

The authors investigated the role of baseline hippocampal volume on later clinical emergence of dementia in a group of older, non-demented depressed individuals. Subjects were 115 depressed, non-demented participants in a mental health clinical research center. All subjects were screened for dementia and agreed to have a magnetic resonance imaging (MRI) brain scan at baseline. Subjects were clinically evaluated by geriatric psychiatrists quarterly for up to 5 years and received annual neuropsychological testing. Bivariate analyses examined age, gender, race, educational level, baseline depression severity, age at depression onset, baseline Mini-Mental State Exam (MMSE), left and right hippocampal volume, and total cerebral volume. Age, baseline MMSE, total cerebral volume, and having a small left hippocampal volume were associated with later dementia and were included in subsequent survival analysis. Small left hippocampal volume was significantly associated with later dementia (hazard ratio=2.762). Small left hippocampal size on neuroimaging may be a marker for dementia in depressed patients who have not yet met criteria for a clinical diagnosis of a dementing disorder.

Key Words: Depression • Dementias (general) • MRI • Hippocampus

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