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Depression, Apolipoprotein E Genotype, and the Incidence of Mild Cognitive Impairment: A Prospective Cohort Study
Abstract
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 (epsilon3/epsilon4 or epsilon4/epsilon4) 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.
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“Depression is characterized not only by feelings of sadness and worthlessness, but also by inertia, lethargy, and impaired cognition that is more prevalent in the elderly (Geda et al., 2006) (Jorm, 2000; Kumar et al., 2006).”
From Biological rhythms, higher brain function, and behavior: Gaps, opportunities, and challenges (2009) · cites this paper as Geda et al., 2006
In the citing paper
“In humans, the incidence of depression and impairments in cognitive function, most notably spatial memory, are higher among the elderly (Geda et al, 2006; Jorm, 2000; Kumar et al., 2006).”
From Biological rhythms, higher brain function, and behavior: Gaps, opportunities, and challenges (2009) · cites this paper as Geda et al, 2006
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Metadata
- Authors
- Geda, Y. E., Knopman, D. S., Mrazek, D. A., Jicha, G. A., Smith, G. E., Negash, S., Boeve, B. F., Ivnik, R. J., Petersen, R. C., Pankratz, V. S., & Rocca, W. A.
- Affiliations
- Mayo Clinic (US)
- ORCID
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2006-03-01
- Volume
- 63
- Issue
- 3
- Pages
- 435
- ISSN
- 0003-9942 (ISSN-L)
- OpenAlex
- W2167153475
- Cited by
- 230
- References
- 36
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 6 · 2023: 8 · 2022: 8 · 2021: 7 · 2020: 8 · 2019: 8 · 2018: 14 · 2017: 6 · 2016: 12 · 2015: 12 · 2014: 12 · 2013: 10 · 2012: 21
- FWCI
- 10.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Mayo Clinic
- National Institute on Aging (P50‐AG16574, U01AG06786, U01AG006786, P50AG016574)
- National Institute of Mental Health (K01-MH68351, K01MH068351)
- National Institute of Neurological Disorders and Stroke (R01-NS33978, R01NS033978)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- depression, APOE genotype, mild cognitive impairment, dementia, older adults, Geriatric Depression Scale, genetic risk factors, synergistic interaction, cognitive decline
- MeSH terms
- Aged, Aged, 80 and over, Apolipoproteins E, Cognition Disorders, Demography, Depression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Risk, Geriatric Assessment, Incidence, Proportional Hazards Models, Survival Analysis
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