title: Increased neurofibrillary tangles in patients with Alzheimer disease with comorbid depression.
abstract: OBJECTIVE
  Recent evidence suggests that a history of major depression may lead to increases in hippocampal neuropathology in Alzheimer disease (AD). The authors tested the hypothesis that neuritic plaques and neurofibrillary tangles are more pronounced in the brains of patients with AD with comorbid depression as compared with patients with AD without depression.
  
  
  METHODS
  Brain samples from patients were selected from the U.S. National Alzheimer's Coordinating Center database. The primary analysis included 7164 individuals: 6468 had AD as the primary neuropathologic diagnosis and 696 were considered neuropathologically normal. Depression at study inclusion was rated as present or absent in consensus conferences. Neuropathologic ratings from the Consortium to Establish a Registry in Alzheimer's Disease rating of neuritic plaques and Braak staging of neurofibrillary tangles were used for between-group analyses.
  
  
  RESULTS
  Brains of patients with AD with comorbid depression showed higher levels of cortical tangle formation than brains of patients with AD without comorbid depression. Results remained stable when controlling for age, gender, level of education, and cognitive status. Within patients with AD, comorbid depression increased the odds for advanced neuropathologic disease stage (odds ratio: 1.47; 95% confidence interval: 1.03-2.08).
  
  
  CONCLUSIONS
  In AD, the presence of depression comorbidity corresponds to increases in AD-related neuropathologic changes beyond age, gender, level of education, and cognitive status, suggesting an interaction between depression and the neuropathologic processes in AD.
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, New York, USA. michael.rapp@charite.de
authors.forename: Michael A
authors.initials: MA
authors.lastname: Rapp
authors.forename: Michal
authors.initials: M
authors.lastname: Schnaider-Beeri
authors.forename: Dushyant P
authors.initials: DP
authors.lastname: Purohit
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Perl
authors.forename: Vahram
authors.initials: V
authors.lastname: Haroutunian
authors.forename: Mary
authors.initials: M
authors.lastname: Sano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016874:Neurofibrillary Tangles / Q000473:pathology*; D016017:Odds Ratio; D058225:Plaque, Amyloid / Q000473:pathology; D012307:Risk Factors