title: Depression as a risk factor for Alzheimer disease: the MIRAGE Study.
abstract: BACKGROUND
  Depression symptoms may be associated with the development of Alzheimer disease (AD).
  
  
  OBJECTIVE
  To evaluate the association between depression symptoms and risk of AD, and to explore the temporal aspects of this association.
  
  
  METHODS
  Academic institutions with specialized memory clinics.
  
  
  METHODS
  Cross-sectional, family-based, case-control study with standardized self- and proxy questionnaires to collect information on depression symptoms and other risk factors.
  
  
  METHODS
  A total of 1953 subjects with AD and 2093 of their unaffected relatives enrolled in the Multi-institutional Research in Alzheimer's Genetic Epidemiology Study.
  
  
  METHODS
  Odds ratios (ORs) of AD were estimated with and without depression symptoms, adjusted for age, sex, education, history of head trauma, and apolipoprotein E status.
  
  
  RESULTS
  There was a significant association between depression symptoms and AD (adjusted OR, 2.13; 95% confidence interval [CI], 1.71-2.67). In families where depression symptoms first occurred within 1 year before the onset of AD, the association was higher (OR, 4.57; 95% CI, 2.87-7.31), while in the families where the depression symptoms first occurred more than 1 year before the onset of AD, the association was lower (OR, 1.38; 95% CI, 1.03-1.85). In families where depression symptoms first occurred more than 25 years before the onset of AD, there was still a modest association (OR, 1.71; 95% CI, 1.03-2.82).
  
  
  CONCLUSIONS
  Depression symptoms before the onset of AD are associated with the development of AD, even in families where first depression symptoms occurred more than 25 years before the onset of AD. These data suggest that depression symptoms are a risk factor for later development of AD.
authors.affiliation: Department of Neurology, Genetics Program, Boston University School of Medicine, MA 02118, USA. rcgreen@bu.edu
authors.forename: Robert C
authors.initials: RC
authors.lastname: Green
authors.forename: L Adrienne
authors.initials: LA
authors.lastname: Cupples
authors.forename: Alex
authors.initials: A
authors.lastname: Kurz
authors.forename: Sanford
authors.initials: S
authors.lastname: Auerbach
authors.forename: Rodney
authors.initials: R
authors.lastname: Go
authors.forename: Dessa
authors.initials: D
authors.lastname: Sadovnick
authors.forename: Ranjan
authors.initials: R
authors.lastname: Duara
authors.forename: Walter A
authors.initials: WA
authors.lastname: Kukull
authors.forename: Helena
authors.initials: H
authors.lastname: Chui
authors.forename: Timi
authors.initials: T
authors.lastname: Edeki
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Griffith
authors.forename: Robert P
authors.initials: RP
authors.lastname: Friedland
authors.forename: David
authors.initials: D
authors.lastname: Bachman
authors.forename: Lindsay
authors.initials: L
authors.lastname: Farrer
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000523:psychology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D003866:Depressive Disorder / Q000453:epidemiology*; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors