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A Family Study of Alzheimer Disease and Early- and Late-Onset Depression in Elderly Patients
Reinhard Heun, MD;
Andreas Papassotiropoulos, MD;
Frank Jessen, MD;
Wolfgang Maier, MD;
John C. S. Breitner, MD
Arch Gen Psychiatry. 2001;58:190-196.
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.
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).
Corresponding author and reprints: Reinhard Heun, MD, Department
of Psychiatry, University of Bonn, Venusberg, D-53105 Bonn, Germany (e-mail: heun{at}uni-bonn.de).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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J Geriatr Psychiatry Neurol 2006;19:160-171.
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Arch Gen Psychiatry 2005;62:565-573.
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