Depression in mild dementia: associations with diagnosis, APOE genotype and clin

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Depression in mild dementia: associations with diagnosis, APOE genotype and

clinical features.

2010 Oct 28

Abstract

BACKGROUND: Depression is common in dementia, with important clinical

implications. Few studies of depression in dementia with Lewy bodies are

available, and the results are inconsistent.

OBJECTIVE: To examine the frequency of depression and its characteristics and

correlates, in people with mild dementia.

METHODS: All referrals for patients with a first time diagnosis of dementia to

geriatric and older psychiatry outpatient clinics in the counties of Rogaland

and Hordaland in Western Norway from March 2005 to March 2007 were screened for

the study. Participants and their caregivers underwent a comprehensive and

standardised diagnostic and assessment procedure. The depression subitem of the

neuropsychiatric inventory (NPId) and Montgomery and Åsberg depression rating

scale (MADRS) were used to estimate depression. Cut-off scores for any

depression were 0/1 (NPId) and 6/7 (MADRS), and for clinically significant

depression 3/4 and 14/15, respectively.

RESULTS: Two hundered and twenty-three subjects with dementia participated, of

whom 59 and 50% showed symptoms of depression assessed by NPI or MADRS,

respectively, and 25 and 16% had clinically significant depression as measured

by NPI and MADRS, respectively. Depression was more frequent in dementia with

Lewy bodies (DLB) than in Alzheimer's disease (AD; p & #8201;< & #8201;0.05). APOE

genotype was available in 153 patients, and in AD, but not in DLB, a general

linear model showed that the presence of APOE & #949;4 allele was significantly

associated with depression (F & #8201;= & #8201;4.14; p & #8201;= & #8201;0.045).

CONCLUSION: Depression is common even in mild dementia, and more common and

severe in DLB compared to AD. Future studies should explore the longitudinal

course of depression in DLB, and the neural underpinnings of depression in DLB.

http://www.ncbi.nlm.nih.gov/pubmed/21031449?dopt=AbstractPlus