 |
|
Depression, Apolipoprotein E Genotype, and the Incidence of Mild Cognitive Impairment
A Prospective Cohort Study
Yonas E. Geda, MD;
David S. Knopman, MD;
David A. Mrazek, MD;
Gregory A. Jicha, PhD, MD;
Glenn E. Smith, PhD;
Selamawit Negash, PhD;
Bradley F. Boeve, MD;
Robert J. Ivnik, PhD;
Ronald C. Petersen, PhD, MD;
V. Shane Pankratz, PhD;
Walter A. Rocca, MD, MPH
Arch Neurol. 2006;63:435-440.
Background It remains unknown whether depression and apolipoprotein E genotype are risk factors for incident mild cognitive impairment (MCI).
Objective To determine whether elderly individuals with depression (measured by the short Geriatric Depression Scale) are at increased risk of developing incident MCI.
Design Prospective cohort study.
Setting Primary care clinic.
Participants A cohort of 840 cognitively normal elderly subjects without depression at recruitment who were followed up prospectively for a median of 3.5 years (range, 0.4-12.8 years). Subjects who developed depression (score of  6 on the short Geriatric Depression Scale; depression cohort) were compared with all remaining subjects (referent cohort).
Main Outcome Measures Incidence of MCI (primary outcome) and incidence of MCI or dementia (composite secondary outcome).
Results Individuals in the depression cohort were at significantly increased risk of subsequent incident MCI (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.2-4.1) after adjusting for age (time scale), sex, and education, and considering dementia as a competing outcome. The association was stronger in men but did not vary by severity of depression. We observed a synergistic interaction between apolipoprotein E genotype ( 3/4 or 4/4) and depression (joint effect HR, 5.1; 95% CI, 1.9-13.6; test for additive interaction, P = .03). We found a similar association between depression and the subsequent composite outcome of incident MCI or dementia (HR, 2.6; 95% CI, 1.6-4.3).
Conclusions Cognitively normal elderly individuals who develop depression are at increased risk of subsequent MCI. We found a synergistic interaction between depression and apolipoprotein E genotype.
Author Affiliations: Departments of Psychiatry and Psychology (Drs Geda, Mrazek, Smith, and Ivnik), Neurology (Drs Knopman, Jicha, Boeve, Petersen, and Rocca), and Health Sciences Research (Drs Petersen, Pankratz, and Rocca), and the Mayo Alzheimer's Disease Research Center (Drs Geda, Smith, Negash, Boeve, Ivnik, and Petersen), Mayo Clinic College of Medicine, Rochester, Minn; and Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Jacksonville, Fla (Dr Geda).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Amyloid-Associated Depression: A Prodromal Depression of Alzheimer Disease?
Sun et al.
Arch Gen Psychiatry 2008;65:542-550.
ABSTRACT
| FULL TEXT
Change in Depressive Symptoms During the Prodromal Phase of Alzheimer Disease
Wilson et al.
Arch Gen Psychiatry 2008;65:439-445.
ABSTRACT
| FULL TEXT
Distinguishing Between Depression and Dementia in Older Persons: Neuropsychological and Neuropathological Correlates
Wright and Persad
J Geriatr Psychiatry Neurol 2007;20:189-198.
ABSTRACT
ApoE4 Allele Is Associated With Late-Life Depression: A Population-Based Study
Yen et al.
AJGP 2007;15:858-868.
ABSTRACT
| FULL TEXT
Longitudinal Magnetic Resonance Imaging Vascular Changes, Apolipoprotein E Genotype, and Development of Dementia in the Neurocognitive Outcomes of Depression in the Elderly Study
Steffens et al.
AJGP 2007;15:839-849.
ABSTRACT
| FULL TEXT
Olfactory Identification and Incidence of Mild Cognitive Impairment in Older Age
Wilson et al.
Arch Gen Psychiatry 2007;64:802-808.
ABSTRACT
| FULL TEXT
Chronic distress and incidence of mild cognitive impairment
Wilson et al.
Neurology 2007;68:2085-2092.
ABSTRACT
| FULL TEXT
Predictors of progression from mild cognitive impairment to Alzheimer disease
Palmer et al.
Neurology 2007;68:1596-1602.
ABSTRACT
| FULL TEXT
A Clinical Approach to Mild Cognitive Impairment
Rosenberg et al.
Am. J. Psychiatry 2006;163:1884-1890.
FULL TEXT
|
