Plasma Amyloid Beta-42 Independently Predicts Both Late-Onset Depression and Alzheimer Disease
Plasma Amyloid Beta-42 Independently Predicts Both Late-Onset Depression and Alzheimer Disease
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DOI：
10.1097/jgp.0b013e3181df48be
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发表时间：
2010-11-01
影响因子：
7.2
通讯作者：
Fischer, Peter
中科院分区：
文献类型：
--
作者：
Blasko, Imrich;Kemmler, Georg;Fischer, Peter
目的：老年抑郁症可能是阿尔茨海默病(AD)的前驱症状。在横断面研究中，在AD前期和抑郁症患者中发现了高水平的血浆淀粉样β-42(Aβ42)。这项研究考察了基线状态下从未抑郁且非痴呆者的样本中出现的晚发性抑郁症(LOD)和AD与血浆Aβ42之间的关系。设计：前瞻性5年纵向研究。参与者：维也纳外达努贝老龄化研究中的一个老年人社区住宅(N=331)。测量：在基线、2.5年和5年的随访中评估实验室测量、认知功能和抑郁症状。结果：在排除AD转换者后，回归分析显示，基线水平较高的血浆Aβ42是LOD转归的积极预测因素。无论2.5岁时有轻度认知障碍(MCI)的人是否被纳入或排除在回归中，基线水平较高的Aβ42是5年后可能或可能发生AD的显著预测因子。较高的AD转换率也与男性相关，但与老年抑郁量表(GDS)、中风或脑梗塞或载脂蛋白E epsilon 4等位基因的较高得分无关。未发现血浆Aβ42水平与GDS之间的相互作用。结论：基线水平较高的血浆Aβ42预示着LOD首发的发生和转化为可能的或可能的AD。在2.5年的随访中，通过GDS评分来衡量出现的抑郁症，无论是单独的还是作为与血浆Aβ42的交互作用因素，都无法预测5年后转化为AD的情况。(《老年精神病学杂志》2010；18：973-982)
Objectives: Depression in the elderly might represent a prodromal phase of Alzheimer disease (AD). High levels of plasma amyloid beta-42 (A beta 42) were found in prestages of AD and also in depressed patients in cross-sectional studies. This study examined the association of emerging late-onset depression (LOD) and AD with plasma A beta 42 in a sample of never depressed and not demented persons at baseline. Design: Prospective 5-year longitudinal study. Participants: A community dwelling of older adults (N = 331) from the Vienna Transdanube Aging study. Measurements: Laboratory measurements, cognitive functioning, and depressive symptoms were assessed at baseline, 2.5, and 5 years follow-ups. Results: After exclusion of converters to AD, regression analysis revealed that higher plasma A beta 42 at baseline was a positive predictor for conversion to first episode of LOD. Independent of whether persons with mild cognitive impairment (MCI) at 2.5 years were included or excluded into regressions, higher plasma A beta 42 at baseline was a significant predictor for the development of probable or possible AD at 5 years. Higher conversion to AD was also associated with male gender but not with either higher scores on the Geriatric Depression Scale (GDS), with stroke or cerebral infarction nor apolipoprotein E epsilon 4 allele. No association was found for an interaction between plasma A beta 42 levels and GDS. Conclusions: Higher plasma A beta 42 at baseline predicted the development of first episode of LOD and conversion to probable or possible AD. Emerging depression as measured by scores on GDS at the 2.5-year follow-up, either alone or as an interaction factor with plasma A beta 42, failed to predict the conversion to AD at 5 years. (Am J Geriatr Psychiatry 2010; 18: 973-982)