Gratitude mediates the link of precuneus volume to depression in older women.

Depression in older people is a major contributor to global disease burden and functional impairment. While trait gratitude, a stable tendency to appreciate others' help, has been shown to alleviate depressive symptoms across populations, less is known about its neuroanatomical substrates and protective neuropsychological mechanisms against depression symptoms in aging populations. Here, we investigated the structural neural correlates of trait gratitude in 120 community-dwelling older women using voxel-based morphometry analysis of T1-weighted magnetic resonance imaging data. First, the whole-brain correlation analysis identified a negative association between trait gratitude and regional gray matter volume (GMV) in the right precuneus. Mediation analyses further suggested that trait gratitude could mediate the impact of regional GMV in right precuneus on depression symptoms. Critically, supplemental analyses showed that the results persisted even after controlling for anxiety and stress symptoms, as well as general personality traits. Our study presents novel evidence for the neuroanatomical basis of trait gratitude in general older women and highlights a brain-personality-symptom pathway for protecting against depression in which GMV affects depressive symptoms via trait gratitude. These findings deepen understanding of gratitude's protective role in late-life mental health while highlighting potential neurostructural markers for resilience against depression.