APOE-epsilon4, depressive symptoms, and cognitive decline in Chinese older adults: Singapore Longitudinal Aging Studies

J Gerontol A Biol Sci Med Sci. 2009 Feb;64(2):306-11. doi: 10.1093/gerona/gln013. Epub 2009 Jan 30.

Abstract

Background: The precise relationship between depression and cognitive decline in older adults is unclear. We investigated the influence of apolipoprotein E (APOE)-epsilon4 genotype in modulating the effect of depressive symptoms on cognitive decline.

Methods: Prospective cohort study of 1,487 cognitively high-functioning Chinese older adults. Depressive symptoms (Geriatric Depression Scale score >/=5) and Mini-Mental State Examination (MMSE) were assessed at baseline, and cognitive decline (at least 1-point drop in MMSE) at 1-2 years after baseline.

Results: There was no significant difference in cognitive decline between depressed (32.9%) and nondepressed (31.5%) participants in the whole sample or among non-APOE-epsilon4 carriers. Among APOE-epsilon4 carriers, depressed participants showed more cognitive decline (40.0%) than their nondepressed counterparts (28.6%), odds ratio = 2.89, 95% confidence interval: 1.03-8.12; p = .04, after controlling for age, gender, education, vascular risk factors/events, smoking, alcohol drinking, physical functioning, subjective memory complaint, length of follow-up, and baseline MMSE scores (p for interaction = .03).

Conclusions: Our study suggests that the presence of the APOE-epsilon4 allele significantly enhanced the risk of cognitive decline associated with depressive symptoms. This finding should be independently replicated in future studies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Aging / genetics*
  • Alleles
  • Apolipoprotein E4 / genetics*
  • Apolipoprotein E4 / metabolism
  • Asian People
  • China / epidemiology
  • Cognition Disorders / ethnology*
  • Cognition Disorders / genetics*
  • Cohort Studies
  • Depressive Disorder / ethnology*
  • Depressive Disorder / genetics*
  • Disease Progression
  • Female
  • Genetic Predisposition to Disease / epidemiology*
  • Geriatric Assessment
  • Heterozygote
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Sex Distribution
  • Singapore / ethnology

Substances

  • Apolipoprotein E4