Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
Psychiatry Investig. 2010 Jun;7(2):135-40. doi: 10.4306/pi.2010.7.2.135. Epub 2010 May 4.
Growing evidence suggests the separate associations of apolipoprotein E e4 allele (apo E4) and depression with incident dementia. This study investigated the separate and combined effects of apo E4 and depression on the incidence of dementia in both men and women.
Of 625 elderly without dementia at baseline, 518 (83%) were followed over a 2.4-year period and were assessed clinically for incident dementia. The apo E polymorphism was ascertained, and depression was identified using the Korean version of the Geriatric Depression Scale (KGDS). Covariates included age, gender, education, disability, alcohol history, physical activity, and vascular risk factors.
The incidence of dementia was significantly higher in elderly Koreans with both apo E4 and depression compared to those without both factors [adjusted odds ratio (95% CI)=5.85 (1.77-19.38)]. This interaction was significant in men (p=0.049), but not in women (p=0.354).
Depressed elderly people are at great risk for incident dementia in the presence of apo E4. Potential gender differences require further evaluation.
越来越多的证据表明载脂蛋白 E e4 等位基因（apoE4）和抑郁与痴呆的发生有关。本研究旨在分别探讨 apoE4 和抑郁对男性和女性发生痴呆的独立和联合影响。
在基线时无痴呆的 625 名老年人中，518 名（83%）在 2.4 年的随访期间进行了临床评估，以确定是否发生痴呆。通过韩国版老年抑郁量表（KGDS）确定 apoE 多态性，并确定抑郁情况。协变量包括年龄、性别、教育程度、残疾、饮酒史、身体活动和血管危险因素。
与既无 apoE4 也无抑郁的老年人相比，同时具有 apoE4 和抑郁的韩国老年人痴呆的发生率显著更高[校正比值比（95%可信区间）=5.85（1.77-19.38）]。这种相互作用在男性中具有统计学意义（p=0.049），但在女性中无统计学意义（p=0.354）。
在存在 apoE4 的情况下，抑郁的老年人群发生痴呆的风险很大。需要进一步评估潜在的性别差异。
