BACKGROUND: Neuropsychiatric research needs to examine the relationships between aetiological, genotypic and clinical risk factors and behavioural phenotypes. These relationships can now be examined in older patients with depressive disorders. METHODS: Key behavioural features, clinical and vascular risk factors and putative genotypes for late-onset neurodegenerative disorders and/or vascular disease were recorded in 78 older patients with depression (mean age = 549 years, S.D. = 14.1) and 22 healthy control subjects (mean age = 55.5 years, S.D. = 9.6). RESULTS: Two or more vascular risks were more common in older patients (65% v. 26% of control subjects, P < 0.01), and in patients with late-onset disorders (82% v. 57% in patients with early-onset disorders, P < 0.05). Patients with late-onset depression had a higher prevalence of the homozygous or heterozygous forms of the C677T mutation of the methylenetetrahydrofolate reductase enzyme (MTHFR)(74% v. 48% in patients with early-onset disorders, P < 0.05). In a multivariate model, only presence of the MTHFR gene mutation predicted late-onset depression (odds ratio = 3.8, 95% CI = 1.1-12.9). Neither apolipoprotein E epsilon 4 or epsilon 2 was associated with depression, late-onset depression, cognitive impairment, or psychomotor change. Patients with apolipoprotein E epsilon 4 were less likely to have psychotic forms of depression. CONCLUSIONS: Patients with late-onset depression had an increased rate of the C677T MTHFR gene mutation and other vascular risk factors. This suggests that a proportion of these patients may have genetically-determined and/or other vascular aetiologies. Patients at risk of these disorders may be assisted by currently-available preventative strategies.
BACKGROUND: Neuropsychiatric research needs to examine the relationships between aetiological, genotypic and clinical risk factors and behavioural phenotypes. These relationships can now be examined in older patients with depressive disorders. METHODS: Key behavioural features, clinical and vascular risk factors and putative genotypes for late-onset neurodegenerative disorders and/or vascular disease were recorded in 78 older patients with depression (mean age = 549 years, S.D. = 14.1) and 22 healthy control subjects (mean age = 55.5 years, S.D. = 9.6). RESULTS: Two or more vascular risks were more common in older patients (65% v. 26% of control subjects, P < 0.01), and in patients with late-onset disorders (82% v. 57% in patients with early-onset disorders, P < 0.05). Patients with late-onset depression had a higher prevalence of the homozygous or heterozygous forms of the C677T mutation of the methylenetetrahydrofolate reductase enzyme (MTHFR)(74% v. 48% in patients with early-onset disorders, P < 0.05). In a multivariate model, only presence of the MTHFR gene mutation predicted late-onset depression (odds ratio = 3.8, 95% CI = 1.1-12.9). Neither apolipoprotein E epsilon 4 or epsilon 2 was associated with depression, late-onset depression, cognitive impairment, or psychomotor change. Patients with apolipoprotein E epsilon 4 were less likely to have psychotic forms of depression. CONCLUSIONS:Patients with late-onset depression had an increased rate of the C677TMTHFR gene mutation and other vascular risk factors. This suggests that a proportion of these patients may have genetically-determined and/or other vascular aetiologies. Patients at risk of these disorders may be assisted by currently-available preventative strategies.
Authors: Shantel L Duffy; Matt Paradise; Ian B Hickie; Simon J G Lewis; Sharon L Naismith; Jim Lagopoulos Journal: J Psychiatry Neurosci Date: 2014-03 Impact factor: 6.186
Authors: Laura B Zahodne; Paola Gilsanz; M Maria Glymour; Laura E Gibbons; Paul Brewster; Jamie Hamilton; Jesse Mez; Jessica R Marden; Kwangsik Nho; Eric B Larson; Paul K Crane; Alden L Gross Journal: Am J Geriatr Psychiatry Date: 2016-10-24 Impact factor: 4.105
Authors: Rita Moretti; Elena Bernobich; Francesca Esposito; Paola Torre; Rodolfo M Antonello; Luisa De Angelis; Giuseppe Bellini Journal: Vasc Health Risk Manag Date: 2011-07-12
Authors: Andrea Ochoa Lopez; Michelle N Martinez; Joshua M Garcia; Mark E Kunik; Luis D Medina Journal: J Affect Disord Date: 2021-06-25 Impact factor: 4.839
Authors: Catherine J Spellicy; Thomas R Kosten; Sara C Hamon; Mark J Harding; David A Nielsen Journal: Front Psychiatry Date: 2013-01-14 Impact factor: 4.157
Authors: Ian B Hickie; Jan Scott; Daniel F Hermens; Elizabeth M Scott; Sharon L Naismith; Adam J Guastella; Nick Glozier; Patrick D McGorry Journal: BMC Med Date: 2013-05-14 Impact factor: 8.775