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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #220395
Title: Amyloid-associated Depression: A Prodromal Depression of Alzheimer’s disease?

Author
item SUN, XIAOYAN - TUFTS-NEMC
item STEFFENS, DAVID - DUKE UNIVERSITY
item AU, RHODA - BOSTON UNIVERSITY
item FOLSTEIN, MARSHAL - TUFTS-NEMC
item SUMMERGRAD, PAUL - TUFTS-NEMC
item YEE, JACQUELINE - TUFTS-NEMC
item Rosenberg, Irwin
item MWAMBURI, MKAYA - TUFTS-NEMC
item QUI, WEI QIAO - TUFTS-NEMC

Submitted to: Archives of General Psychiatry
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/30/2007
Publication Date: 5/1/2008
Citation: Sun, X., Steffens, D.C., Au, R., Folstein, M., Summergrad, P., Yee, J., Rosenberg, I., Mwamburi, M., Qui, W. 2008. Amyloid-associated Depression: A Prodromal Depression of Alzheimer’s disease?. Archives Of General Psychiatry. 65(5):542-550.

Interpretive Summary: This study was designed to characterize blood AB40/AB42 ratio (two forms of an amyloid protein associated with Alzheimer’s disease) and cognitive function in the elderly with and without depression. We evaluated 995 homebound elders in a cross-sectional study. Subjects were defined as depressed if they had a high depression score. Subjects with depression had lower plasma AB42 (Median: 14.1 vs. 19.2, P = 0.006) and a higher plasma AB40/AB42 ratio (Median: 8.9 vs. 6.4, P = 0.0006) than those without depression in the absence of cardiovascular disease (CVD) and antidepressant usage. The interaction between depression and plasma AB40/AB42 ratio was associated with lower memory score. Relative to those without depression, "amyloid-associated depression," defined by presence of depression and a high plasma AB40/AB42 ratio, was associated with greater impairment in memory along with two impaired function in two other cognitive tests of visuospatial ability and executive function. In contrast, non-amyloid depression was not associated with memory impairment but with other cognitive disabilities. The combination of depression and a high blood AB40/AB42 ratio presenting with memory impairment, may define a depression subtype and represent an early manifestation of Alzheimer’s Disease.

Technical Abstract: This study was designed to characterize plasma Abeta40/Abeta42 ratio and cognitive function in the elderly with and without depression.We evaluated 995 homebound elders in a cross-sectional study. Subjects were defined as depressed if they had a Center for Epidemiological Studies Depression (CES-D) score > 16. Plasma Abeta40 and Abeta42 peptides were measured.Subjects with depression had lower plasma Abeta42 (Median: 14.1 vs. 19.2, P = 0.006) and a higher plasma Abeta40/Abeta42 ratio (Median: 8.9 vs. 6.4, P = 0.0006) than those without depression in the absence of cardiovascular disease (CVD) and antidepressant usage. The interaction between depression and plasma Abeta40/Abeta42 ratio was associated with lower memory score (Logical Memory Delayed Recall: beta = -1.9, SE = 0.7, P = 0.006) and poorer language ability (Verbal Fluency: beta = - 1.8, SE = 0.9, P = 0.05) after adjusting for potentially confounding variables including CVD and antidepressant use. Relative to those without depression, "amyloid-associated depression," defined by presence of depression and a high plasma Abeta40/Abeta42 ratio, was associated with greater impairment in memory, visuospatial ability and executive function; in contrast, non-amyloid depression was not associated with memory impairment but with other cognitive disabilities. The combination of depression and a high plasma Abeta40/Abeta42 ratio presents with memory impairment, which may define an amyloid-associated depression subtype and represent a prodromal manifestation of AD.