Dissertations, Theses, and Capstone Projects
Date of Degree
9-2024
Document Type
Dissertation
Degree Name
Ph.D.
Program
Psychology
Advisor
Joel Sneed
Committee Members
Valentina Nikulina
Justin Storbeck
Laura Rabin
David Rindskopf
Subject Categories
Psychology
Keywords
late life depression; treatment response; vascular depression; neuroanatomy
Abstract
Late-life depression (LLD) is associated with poor response to antidepressant medication treatment, cognitive impairment, cerebrovascular disease, and brain changes both in white and gray matter. Of particular interest is the vascular subtype of LLD, vascular depression (VD). Although LLD and VD have received considerable research attention, there are still areas that must be further clarified to adequately characterize aspects of LLD and VD that provide valuable information for possible interventions. Such areas include a stronger understanding of the moderating role of brain atrophy and changes in cognition in treatment response in LLD. This dissertation consists of three separate studies aimed at addressing gaps in the literature on LLD and treatment response. By better ascertaining the relationships between vascular risk, brain atrophy, cognitive changes, and treatment response in LLD, information integral to clarifying the late-life subtype of VD is established. The first study evaluated measures of cortical thickness and hippocampal volume between LLD patients with and without vascular risk. The second study used data from a placebo-controlled trial to evaluate the relationship between white matter hyperintensity (WMH) volume, executive function, processing speed, and treatment response in LLD. As literature investigating the relationship between WMH and treatment response is inconsistent, the third study utilized meta-analytic methods to critically evaluate data of well-controlled treatment response outcome studies in LLD and determine whether WMH do in fact predict treatment response in this population. The three studies together aid in further evaluation of the validity of the VD hypothesis and results shed light on areas important for clinical implications and future research.
Recommended Citation
Egglefield, Dakota, "Late-Life Depression: The Interplay Between Cerebrovascular Risk, Cortical and Subcortical Atrophy, and Treatment Response" (2024). CUNY Academic Works.
https://academicworks.cuny.edu/gc_etds/5958