A Family Study of Alzheimer Disease and Early- and Late-Onset Depression in Elderly Patients | Dementia and Cognitive Impairment | JAMA Psychiatry | JAMA Network
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Original Article
February 2001

A Family Study of Alzheimer Disease and Early- and Late-Onset Depression in Elderly Patients

Author Affiliations

From the Department of Psychiatry, University of Bonn, Bonn, Germany (Drs Heun, Papassotiropoulos, Jessen, and Maier); and the Department of Mental Hygiene, The Johns Hopkins School of Public Health, Baltimore, Md (Dr Breitner).

Arch Gen Psychiatry. 2001;58(2):190-196. doi:10.1001/archpsyc.58.2.190
Abstract

Background  The substantial symptomatic overlap between depression and dementia in old age may be explained by common genetic vulnerability factors.

Methods  We investigated this idea by comparing the occurrence of both disorders in first-degree relatives of 78 patients with Alzheimer disease (AD), of 74 with late-onset depression (onset age of ≥60 years), of 78 with early-onset depression, of 53 with comorbid lifetime diagnoses of AD/depression, and of 162 population control subjects. Diagnostic information on their 3002 relatives was obtained from structured direct assessments and from family history interviews.

Results  The 90-year lifetime incidence of primary progressive dementia was significantly higher in relatives of patients with AD (30%) and comorbid AD/depression (27%) than in relatives of patients with early-onset (21%) or late-onset (26%) depression, or of controls (22%) (P = .01). Lifetime incidence of depression was significantly higher in relatives of patients with early-onset depression (13%) than in relatives of patients with AD (10%) or controls (9.0%) (P = .006). Lifetime incidence of depression was similar in control relatives and in relatives of those patients with comorbid AD/depression (8.6%). Relatives of patients with late-onset depression also showed similar occurrence of depression until the age of 80 years, but the figure increased sharply thereafter to 19.1% by the age of 90 years.

Conclusions  Primary progressive dementia and early-onset depression represent clinical entities with distinct inheritance. Late-onset depression does not share substantial inheritance in common with dementia or with early-onset depression, but does show modest familial clustering.

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