Background
Lipids appear to mediate depressive vulnerability in the elderly; however, sex differences
and genetic vulnerability have not been taken into account in previous prospective
studies.
Methods
Depression was assessed in a population of 1040 women and 752 men aged 65 years and
older at baseline and after 7-year follow-up. Clinical level of depression (DEP) was
defined as having either a score of 16 or higher on the Centre for Epidemiology Studies
Depression scale or a diagnosis of current major depression on the Mini-International
Neuropsychiatric Interview. Lipid levels, apolipoprotein E, and serotonin transporter
linked promoter region (5-serotonin transporter gene linked promoter region) genotypes
were evaluated at baseline.
Results
Multivariate analyses adjusted by sociodemographic and behavioral variables, measures
of physical health including ischemic pathologies, and genetic vulnerability indicated
gender-specific associations between dyslipidemia and DEP, independent of the use
of lipid-lowering agents or apolipoprotein E status. Men with low low-density lipoprotein
cholesterol levels had twice the risk of prevalent and incident DEP, whereas in women
low high-density lipoprotein cholesterol levels were found to be significantly associated
with increased prevalent DEP (odds ratio = 1.5) only. A significant interaction was
observed between low low-density lipoprotein-cholesterol and 5-serotonin transporter
gene linked promoter region genotype, men with s/s or s/l genotype being at increased risk of DEP (odds ratio = 6.0 and 2.7, respectively).
No significant gene–environment interaction was observed for women.
Conclusions
DEP is associated with higher atherogenic risk in women (low high-density lipoprotein
cholesterol), whereas the reverse is observed in men (low low-density lipoprotein
cholesterol). Late-life depression may have a complex gender-specific etiology involving
genetic vulnerability in men.
Key Words
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Article Info
Publication History
Published online: May 31, 2010
Accepted:
April 8,
2010
Received in revised form:
April 2,
2010
Received:
December 18,
2009
Identification
Copyright
© 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
