title: Depression in mild dementia: associations with diagnosis, APOE genotype and clinical features.
abstract: BACKGROUND
  Depression is common in dementia, with important clinical implications. Few studies of depression in dementia with Lewy bodies are available, and the results are inconsistent.
  
  
  OBJECTIVE
  To examine the frequency of depression and its characteristics and correlates, in people with mild dementia.
  
  
  METHODS
  All referrals for patients with a first time diagnosis of dementia to geriatric and older psychiatry outpatient clinics in the counties of Rogaland and Hordaland in Western Norway from March 2005 to March 2007 were screened for the study. Participants and their caregivers underwent a comprehensive and standardised diagnostic and assessment procedure. The depression subitem of the neuropsychiatric inventory (NPId) and Montgomery and Åsberg depression rating scale (MADRS) were used to estimate depression. Cut-off scores for any depression were 0/1 (NPId) and 6/7 (MADRS), and for clinically significant depression 3/4 and 14/15, respectively.
  
  
  RESULTS
  Two hundered and twenty-three subjects with dementia participated, of whom 59 and 50% showed symptoms of depression assessed by NPI or MADRS, respectively, and 25 and 16% had clinically significant depression as measured by NPI and MADRS, respectively. Depression was more frequent in dementia with Lewy bodies (DLB) than in Alzheimer's disease (AD; p < 0.05). APOE genotype was available in 153 patients, and in AD, but not in DLB, a general linear model showed that the presence of APOEε4 allele was significantly associated with depression (F = 4.14; p = 0.045).
  
  
  CONCLUSIONS
  Depression is common even in mild dementia, and more common and severe in DLB compared to AD. Future studies should explore the longitudinal course of depression in DLB, and the neural underpinnings of depression in DLB.
authors: Department for Geriatric Psychiatry, Psychiatric Clinic, Stavanger University Hospital, Hillevåg, Stavanger, Norway. ffri@sus.no
authors: Friederike
authors: F
authors: Fritze
authors: Uwe
authors: U
authors: Ehrt
authors: Hogne
authors: H
authors: Sønnesyn
authors: Martin
authors: M
authors: Kurz
authors: Tibor
authors: T
authors: Hortobágyi
authors: Sabine Piepenstock
authors: SP
authors: Nore
authors: Clive
authors: C
authors: Ballard
authors: Dag
authors: D
authors: Aarsland
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D053327:Apolipoprotein E4 / Q000235:genetics*; D003704:Dementia / Q000235:genetics* / Q000523:psychology*; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005838:Genotype; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales
chemical_list: D053327:Apolipoprotein E4