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History of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease.

Abstract

BACKGROUND

Depression may increase risk for Alzheimer disease (AD), but it is not clear whether this risk is mediated by structural brain changes. We determined whether history of depressive episodes and presence of depressive symptoms were associated with smaller hippocampal and amygdalar volumes and with increased risk for incident AD.

METHODS

Within the Rotterdam Scan Study 503 persons, aged 60-90 years at baseline and without dementia, reported their history of depressive episodes. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale. Volumetric assessment of the hippocampus and amygdala was performed using three-dimensional MRI. All subjects were followed for an average of 6 years for development of AD, diagnosed according to National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria.

RESULTS

A total of 134 subjects (26.6%) reported a history of depression (88 reported an onset <60 years and 46 a late onset). Multiple linear regression analyses did not reveal a significant association with hippocampal or amygdalar volume for any of the depression parameters. During follow-up, 33 persons developed AD. Cox regression analyses showed that subjects with early onset depression had an increased risk for AD (HR 3.76; 95% CI 1.41 to 10.06), independent of hippocampal and amygdalar volume, whereas this risk was 2.34 (95% CI 0.82 to 6.69) in subjects with a late-onset depression. Depressive symptoms at baseline were not associated with increased risk for AD.

CONCLUSION

History of depression, and particularly an early onset, but not presence of depressive symptoms increased the risk for Alzheimer disease. This risk was not mediated by smaller hippocampal or amygdalar volumes.

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  • Authors+Show Affiliations

    ,

    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.

    , , ,

    Source

    Neurology 70:15 2008 Apr 08 pg 1258-64

    MeSH

    Age of Onset
    Aged
    Aged, 80 and over
    Alzheimer Disease
    Amygdala
    Atrophy
    Comorbidity
    Depressive Disorder
    Female
    Hippocampus
    Humans
    Linear Models
    Male
    Middle Aged
    Neuropsychological Tests
    Predictive Value of Tests
    Prognosis
    Risk Factors
    Temporal Lobe

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18391157

    Citation

    Geerlings, M I., et al. "History of Depression, Depressive Symptoms, and Medial Temporal Lobe Atrophy and the Risk of Alzheimer Disease." Neurology, vol. 70, no. 15, 2008, pp. 1258-64.
    Geerlings MI, den Heijer T, Koudstaal PJ, et al. History of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease. Neurology. 2008;70(15):1258-64.
    Geerlings, M. I., den Heijer, T., Koudstaal, P. J., Hofman, A., & Breteler, M. M. (2008). History of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease. Neurology, 70(15), pp. 1258-64. doi:10.1212/01.wnl.0000308937.30473.d1.
    Geerlings MI, et al. History of Depression, Depressive Symptoms, and Medial Temporal Lobe Atrophy and the Risk of Alzheimer Disease. Neurology. 2008 Apr 8;70(15):1258-64. PubMed PMID: 18391157.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - History of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease. AU - Geerlings,M I, AU - den Heijer,T, AU - Koudstaal,P J, AU - Hofman,A, AU - Breteler,M M B, PY - 2008/4/9/pubmed PY - 2008/5/16/medline PY - 2008/4/9/entrez SP - 1258 EP - 64 JF - Neurology JO - Neurology VL - 70 IS - 15 N2 - BACKGROUND: Depression may increase risk for Alzheimer disease (AD), but it is not clear whether this risk is mediated by structural brain changes. We determined whether history of depressive episodes and presence of depressive symptoms were associated with smaller hippocampal and amygdalar volumes and with increased risk for incident AD. METHODS: Within the Rotterdam Scan Study 503 persons, aged 60-90 years at baseline and without dementia, reported their history of depressive episodes. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale. Volumetric assessment of the hippocampus and amygdala was performed using three-dimensional MRI. All subjects were followed for an average of 6 years for development of AD, diagnosed according to National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria. RESULTS: A total of 134 subjects (26.6%) reported a history of depression (88 reported an onset <60 years and 46 a late onset). Multiple linear regression analyses did not reveal a significant association with hippocampal or amygdalar volume for any of the depression parameters. During follow-up, 33 persons developed AD. Cox regression analyses showed that subjects with early onset depression had an increased risk for AD (HR 3.76; 95% CI 1.41 to 10.06), independent of hippocampal and amygdalar volume, whereas this risk was 2.34 (95% CI 0.82 to 6.69) in subjects with a late-onset depression. Depressive symptoms at baseline were not associated with increased risk for AD. CONCLUSION: History of depression, and particularly an early onset, but not presence of depressive symptoms increased the risk for Alzheimer disease. This risk was not mediated by smaller hippocampal or amygdalar volumes. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/18391157/History_of_depression_depressive_symptoms_and_medial_temporal_lobe_atrophy_and_the_risk_of_Alzheimer_disease_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=18391157 DB - PRIME DP - Unbound Medicine ER -