Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Vonetta Dotson

Second Advisor

Sharee Light

Third Advisor

Elizabeth Tighe

Fourth Advisor

Erin Tone


The vascular depression hypothesis, which posits that late-life depression may have a vascular origin, is supported by research findings of greater severity of white matter lesions in older adults with elevated depressive symptoms, reflected in white matter hyperintensities (WMH) on neuroimaging. Furthermore, WMH increases are more severe in individuals with late-onset depression and are associated with a distinct depressive symptom presentation. A growing body of work has focused on symptom-based approaches to understanding depression in older adults primarily using factor analytic methods to examine symptom dimensions of depression. However, few studies have used person-centered approach that may show subtle differences in symptom profiles of depression among older adults. The current study aimed to identify symptom profiles of late-onset depression and explore associations with WMH using data from the large-scale National Alzheimer’s Coordinating Center Data Set. Participants were 65 years and older, and without a history of depression in earlier life. Latent class analyses resulted in three qualitatively distinct symptom profiles – General Depression, Motivation/Withdrawal and Asymptomatic. The Motivation/Withdrawal symptom profile was associated with larger WMH volume compared to the General Depression and Asymptomatic symptom profile, but the comparison with General Depression was not significantly different. Results provide support for the idea that amotivation and withdrawal in later life may be more associated with vascular pathology. The current study findings highlight the importance and benefits of a symptom-based approach to depression in older adults.


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