BACKGROUND: Depression is common after hip fracture and is associated with poorer functional recovery. Polymorphisms of the serotonin 1a (5HTR1A) and 2a receptors (5HTR2A) are associated with depression; therefore, we examined their association with depressive symptoms and functional recovery after hip fracture. METHODS: 145 elderly women were followed for 12 months after hip fracture. Depressive symptoms were measured with the 15-item Geriatric Depression Scale (GDS). Functional status was measured by Lower Extremity Physical and Instrumental Activity of Daily Living scales (LPADLs and IADLs). Time-adjusted general linear regression models compared mean GDS between those with and without risk alleles for 5HTR1A and 5HTR2A. RESULTS: Women with 1-2 copies of the 5HTR1A (-1019) G allele had higher GDS scores (Adjusted Mean Difference=0.59; 95% CI, 0.12-1.06), and poorer IADL scores (Adjusted Mean Difference=0.24; 95%CI -0.002 to 0.49), compared to those without this allele, controlling for potential confounders and 5HTR2A. Depressive symptoms partly accounted for poorer IADL recovery. Women with 1-2 copies of the 5HTR2A (-1438) C allele did not have significantly higher GDS scores (Adjusted Mean Difference=0.34; 95%CI, -0.20 to 0.87) and had better IADL scores (Adjusted Mean Difference=-0.40; 95%CI -0.74 to 0.06) than those with A/A genotype. LIMITATIONS: The findings are limited by small sample size and the use of a screening scale to measure depression. CONCLUSIONS: The 5HTR1A (-1019) G allele is associated with increased depressive symptoms after hip fracture, which in turn accounts for poorer functional recovery. These results suggest a role for serotonergic genetic variation in elderly persons' resilience and recovery from medical events.
BACKGROUND:Depression is common after hip fracture and is associated with poorer functional recovery. Polymorphisms of the serotonin 1a (5HTR1A) and 2a receptors (5HTR2A) are associated with depression; therefore, we examined their association with depressive symptoms and functional recovery after hip fracture. METHODS: 145 elderly women were followed for 12 months after hip fracture. Depressive symptoms were measured with the 15-item Geriatric Depression Scale (GDS). Functional status was measured by Lower Extremity Physical and Instrumental Activity of Daily Living scales (LPADLs and IADLs). Time-adjusted general linear regression models compared mean GDS between those with and without risk alleles for 5HTR1A and 5HTR2A. RESULTS:Women with 1-2 copies of the 5HTR1A (-1019) G allele had higher GDS scores (Adjusted Mean Difference=0.59; 95% CI, 0.12-1.06), and poorer IADL scores (Adjusted Mean Difference=0.24; 95%CI -0.002 to 0.49), compared to those without this allele, controlling for potential confounders and 5HTR2A. Depressive symptoms partly accounted for poorer IADL recovery. Women with 1-2 copies of the 5HTR2A (-1438) C allele did not have significantly higher GDS scores (Adjusted Mean Difference=0.34; 95%CI, -0.20 to 0.87) and had better IADL scores (Adjusted Mean Difference=-0.40; 95%CI -0.74 to 0.06) than those with A/A genotype. LIMITATIONS: The findings are limited by small sample size and the use of a screening scale to measure depression. CONCLUSIONS: The 5HTR1A (-1019) G allele is associated with increased depressive symptoms after hip fracture, which in turn accounts for poorer functional recovery. These results suggest a role for serotonergic genetic variation in elderly persons' resilience and recovery from medical events.
Authors: M Jansson; M Gatz; S Berg; B Johansson; B Malmberg; G E McClearn; M Schalling; N L Pedersen Journal: Am J Med Genet B Neuropsychiatr Genet Date: 2003-07-01 Impact factor: 3.568
Authors: J Magaziner; W Hawkes; J R Hebel; S I Zimmerman; K M Fox; M Dolan; G Felsenthal; J Kenzora Journal: J Gerontol A Biol Sci Med Sci Date: 2000-09 Impact factor: 6.053
Authors: E J Lenze; J C Rogers; L M Martire; B H Mulsant; B L Rollman; M A Dew; R Schulz; C F Reynolds Journal: Am J Geriatr Psychiatry Date: 2001 Impact factor: 4.105
Authors: Allison C Nugent; Paul J Carlson; Earle E Bain; William Eckelman; Peter Herscovitch; Husseini Manji; Carlos A Zarate; Wayne C Drevets Journal: J Psychopharmacol Date: 2013-08-07 Impact factor: 4.153
Authors: Kerri S Rawson; David Dixon; Petra Nowotny; William M Ricci; Ellen F Binder; Thomas L Rodebaugh; Leah Wendleton; Peter Doré; Eric J Lenze Journal: PLoS One Date: 2015-03-17 Impact factor: 3.240