| Depression, the most common mental disorder, is the leading cause of years lived with disability and responsible for the majority of the more than 800,000 suicides annually. In addition, individuals with depression are more likely to have comorbid chronic diseases. Determination of dietary factors related to the incidence of late-life depression, presence of ischemic brain lesions, and depression outcomes is needed in order to characterize better the complex relationship between depression and vascular disease. Vascular nutritional factors (dietary attributes believed to either promote or prevent cardiovascular disease) were examined in three groups of elderly individuals: vascular depression, non-vascular depression, and comparison subjects. These same dietary factors were examined for their relationship to brain lesion volume in those with vascular depression. Dietary quality was assessed as a predictor of both depression outcome and lesion volume progression.; Nutrient intake was assessed in elderly depression and comparison subjects using a Block 1998 food frequency questionnaire. Brain lesion volumes were calculated from magnetic resonance imaging (MRI). Depression subtype (vascular or non-vascular) was determined by the extent of hyperintensities on brain MRI. All subjects received medical comorbidity assessments, and depression subjects received psychiatric assessment and treatment.; Vascular nutritional factors were found to differ between depression and comparison subjects but tended to be similar across the two depression groups, while most factors were unassociated with brain lesion volume. Depression subjects (both groups) consumed more cholesterol, trans-unsaturated fat, and high-fat dairy products, had higher body mass index (BMI) values and Keys scores, and consumed less fruit than comparison subjects. High-fat dairy and whole grain consumption were significantly and positively correlated with brain lesion volume, even after adjustment for age, sex, hypertension, diabetes, and total kilocalories. Dietary quality was not associated with longitudinal change in depression score or lesion volume.; These findings may indicate the influence of "vascular" nutrients on late-life depression, regardless of the presence of comorbid cerebrovascular disease. The less healthful diets of depression subjects may have important implications for management of comorbid chronic diseases that are commonly associated with depression. |
