Major depression in primary dementia. Clinical and neuropathologic correlates

G. S. Zubenko and J. Moossy
Department of Psychiatry and Geriatric Health Services, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213.

Cytopathologic features were quantified in seven brain regions in the brains of 37 demented patients, with or without major depression, and in those of seven controls with no history of dementia or depression. The middle frontal and superior temporal cortex, prosubiculum and entorhinal cortex of the hippocampus, nucleus basalis of Meynert, locus ceruleus, and substantia nigra were the areas evaluated. Patients with major depression had significantly more degenerative findings in the locus ceruleus and substantia nigra than demented patients who were not depressed. In contrast, these groups were similar with respect to other clinical features and indexes of global severity of dementia. A logistic regression model that included the degenerative features of both the locus ceruleus and the substantia nigra was significantly better at predicting the presence of major depression than those employing the characteristics of either pigmented nucleus alone. Our results indicate that the development of major depression in patients with primary dementia is associated with the degeneration of the locus ceruleus and substantia nigra.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Distinguishing Between Depression and Dementia in Older Persons: Neuropsychological and Neuropathological Correlates
Wright and Persad
J Geriatr Psychiatry Neurol 2007;20:189-198.
ABSTRACT  

Research Agenda for DSM-V: Diagnostic Categories and Criteria for Neuropsychiatric Syndromes in Dementia
Jeste et al.
J Geriatr Psychiatry Neurol 2006;19:160-171.
ABSTRACT  

Cerebral Infarctions and the Relationship of Depression Symptoms to Level of Cognitive Functioning in Older Persons
Bennett et al.
AJGP 2004;12:211-219.
ABSTRACT | FULL TEXT  

Depressive symptoms, clinical AD, and cortical plaques and tangles in older persons
Wilson et al.
Neurology 2003;61:1102-1107.
ABSTRACT | FULL TEXT  

Psychiatric Symptoms Vary With the Severity of Dementia in Probable Alzheimer's Disease
Lopez et al.
J. Neuropsychiatry Clin. Neurosi. 2003;15:346-353.
ABSTRACT | FULL TEXT  

A Collaborative Study of the Emergence and Clinical Features of the Major Depressive Syndrome of Alzheimer's Disease
Zubenko et al.
Am. J. Psychiatry 2003;160:857-866.
ABSTRACT | FULL TEXT  

Depressive symptoms, cognitive decline, and risk of AD in older persons
Wilson et al.
Neurology 2002;59:364-370.
ABSTRACT | FULL TEXT  

Association between the APOE genotype and psychopathologic symptoms in Alzheimer's disease
Scarmeas et al.
Neurology 2002;58:1182-1188.
ABSTRACT | FULL TEXT  

Research evaluation and diagnosis of possible Alzheimer's disease over the last two decades: II
Lopez et al.
Neurology 2000;55:1863-1869.
ABSTRACT | FULL TEXT  

Depression and risk of cognitive decline and Alzheimer's disease: Results of two prospective community-based studies in The Netherlands
GEERLINGS et al.
Br. J. Psychiatry 2000;176:568-575.
ABSTRACT | FULL TEXT  

The Temporal Relationship Between Depressive Symptoms and Dementia: A Community-Based Prospective Study
Chen et al.
Arch Gen Psychiatry 1999;56:261-266.
ABSTRACT | FULL TEXT  

Neurobiological correlates of a putative risk allele for Alzheimer's disease on chromosome 12q
Zubenko et al.
Neurology 1999;52:725-725.
ABSTRACT | FULL TEXT  

The Neurobiology and Pharmacotherapy of Alzheimer's Disease
Felician and Sandson
J. Neuropsychiatry Clin. Neurosi. 1999;11:19-31.
ABSTRACT | FULL TEXT  

Lack of Association Between Depression and Loss of Neurons in the Locus Coeruleus in Alzheimer Disease
Hoogendijk et al.
Arch Gen Psychiatry 1999;56:45-51.
ABSTRACT | FULL TEXT  

Depressive Symptomatology and Incident Cognitive Decline in an Elderly Community Sample
Bassuk et al.
Arch Gen Psychiatry 1998;55:1073-1081.
ABSTRACT | FULL TEXT  

Higher Cerebrospinal Fluid MHPG in Subjects With Dementia of the Alzheimer Type: Relationship With Cognitive Dysfunction
Sheline et al.
AJGP 1998;6:155-161.
ABSTRACT | FULL TEXT  

Biologic Markers and Neurochemical Correlates of Agitation and Psychosis in Dementia
Kirby and Lawlor
J Geriatr Psychiatry Neurol 1995;8:S2-S7.
ABSTRACT  

Is there a distinct subtype of major depression in the elderly?
Baldwin
J Psychopharmacol 1994;8:177-184.
ABSTRACT  

Delusions, hallucinations and depression in Alzheimer's disease: A biological perspective
Flint
AM J ALZHEIMERS DIS OTHER DEMEN 1991;6:21-28.
ABSTRACT  

Pharmacodynamic Issues Relevant to Geriatric Psychopharmacology
Pollock et al.
J Geriatr Psychiatry Neurol 1990;3:221-228.
 

Assessment of Behavioral and Affective Symptoms in Alzheimer's Disease
Patterson et al.
J Geriatr Psychiatry Neurol 1990;3:21-30.
ABSTRACT