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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access published online on January 30, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, doi:10.1093/gerona/gln013
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org.

APOE-{epsilon}4, Depressive Symptoms, and Cognitive Decline in Chinese Older Adults: Singapore Longitudinal Aging Studies

Mathew Niti1,2, Keng-Bee Yap1,3, Ee-Heok Kua1,2 and Tze-Pin Ng1,2

1 Gerontological Research Programme
2 Department of Psychological Medicine, National University of Singapore
3 Department of Geriatric Medicine, Alexandra Hospital, Singapore

Address correspondence to Tze-Pin Ng, MD, Gerontological Research Programme, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074. Email: pcmngtp{at}nus.edu.sg


  Abstract

Background.: The precise relationship between depression and cognitive decline in older adults is unclear. We investigated the influence of apolipoprotein E (APOE)-{epsilon}4 genotype in modulating the effect of depressive symptoms on cognitive decline.

Methods.: Prospective cohort study of 1,487 cognitively high-functioning Chinese older adults. Depressive symptoms (Geriatric Depression Scale score ≥5) and Mini-Mental State Examination (MMSE) were assessed at baseline, and cognitive decline (at least 1-point drop in MMSE) at 1–2 years after baseline.

Results.: There was no significant difference in cognitive decline between depressed (32.9%) and nondepressed (31.5%) participants in the whole sample or among non–APOE-{epsilon}4 carriers. Among APOE-{epsilon}4 carriers, depressed participants showed more cognitive decline (40.0%) than their nondepressed counterparts (28.6%), odds ratio = 2.89, 95% confidence interval: 1.03–8.12; p = .04, after controlling for age, gender, education, vascular risk factors/events, smoking, alcohol drinking, physical functioning, subjective memory complaint, length of follow-up, and baseline MMSE scores (p for interaction = .03).

Conclusions.: Our study suggests that the presence of the APOE-{epsilon}4 allele significantly enhanced the risk of cognitive decline associated with depressive symptoms. This finding should be independently replicated in future studies.

Keywords Depression; Cognition; Dementia; Apolipoprotein E

Received: November 7, 2007; Accepted: March 14, 2008

Decision Editor: Luigi Ferrucci, MD, PhD


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