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A 9-Year Prospective Population-Based Study on the Association Between the APOE*E4 Allele and Late-Life Depression in Sweden

      Abstract

      Background

      It is well established that there is an association between the apolipoprotein E (APOE) ε4 allele (APOE*E4) and Alzheimerʼs disease. It is less clear whether there is also an association with geriatric depression. We examined the relationship between APOE*E4 and 5-year incidence of depression in a Swedish population-based sample of older adults without dementia and excluding older adults who developed dementia within 4 years after the diagnosis of depression.

      Methods

      In 2000–2001, 839 women and men (age range, 70–92 years; mean age, 73.8 years) free from dementia and depression underwent neuropsychiatric and neuropsychological examinations and genotyping of the APOE*E4 allele. Follow-up evaluations were conducted in 2005 and 2009.The association between APOE*E4 allele and 5-year incidence of depression was examined, while avoiding possible confounding effects of clinical or preclinical dementia by excluding participants who had dementia at study entry, subsequently developed dementia during the 9-year follow-up period, or had a decline in Mini-Mental State Examination score of ≥5 points.

      Results

      Among subjects without depression at study entry and without dementia or significant cognitive decline during the subsequent 9 years, APOE*E4 was prospectively associated with more severe depressive symptoms (b = 1.56, p = .007), incident minor depression (odds ratio = 1.99 [confidence interval = 1.11–3.55], p = .020), and any depression (odds ratio = 1.75 [confidence interval = 1.01–3.03], p = .048).

      Conclusions

      The presence of the APOE*E4 allele predicted future depression in this Swedish population study, even after excluding depressed individuals who later developed dementia, suggesting that the APOE*E4 allele could potentially identify people at high risk for clinically significant depression.

      Keywords

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      Linked Article

      • APOEε4 and Depression: Following a Winding Road
        Biological PsychiatryVol. 78Issue 10
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          Is there an association between having one or two copies of the APOEε4 allele and depression? If yes, what are the explanations for this association, and what clues does it provide about the mechanisms, prevention, or treatment of depression? Two notable features of the literature in this area are the variation in published reports concerning whether or not there is an association and the complexity of interpretation presented by these reports.
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