The influence of subcortical ischemic lesions on cognitive function and quality of life in late life depression

Objectives: Subcortical ischemic lesions (SIL) are known to contribute to the pathogenesis of late life depression. The present study examined the influence of SIL on cognitive function and quality of life in elderly Koreans with major depressive disorder (MDD). Methods: MDD patients (n=86) underwent CT scans and were classified as having SIL if they had a score of 2 or above on age-related white matter changes (ARWMC) scale. Demographic data, psychiatric, medical history, neuropsychological test, quality of life, and depressive symptomatology were compared between MDD patients with and without SIL Results: SIL with grade 2 or above were found in deep white matter of 22 (25.6%) depressed patients and in basal ganglia of 9 (10.5%) depressed patients. Depressed patients with deep white matter lesions showed poor performance on MMSE-KC and decreased quality of life, particularly in physical function and physical role limitation, as compared to depressed patients without deep white matter lesions. Conclusion: These data support that SIL may cause general cognitive dysfunction and poor physical health. More attention should be paid to detection and management of SIL in late life depression in clinical setting. (C) 2011 Elsevier B.V. All rights reserved.