Differential effects of white matter hyperintensity on geriatric depressive symptoms according to APOE-ε4 status.
BACKGROUND
We aimed to examine differential effects of WMH on progression of depressive symptoms according to APOE ε4 status in the elderly.


METHODS
We obtained data from elderly Korean subjects (n=707) aged 60 years or older at baseline from the CREDOS study from November 2005 to July 2014. A linear mixed model stratified according to APOE genotype (APOE ε4 carrier vs. non-carrier) was constructed using GDS score as a primary outcome and degree of overall, deep, periventricular WMH evaluated by a visual rating scale as a risk factor of interest. We also tested interaction between APOE ε4, WMH and time as predictors of clinical progression on GDS scores to examine the moderating effect of APOE ε4 allele on the relationship between degree of WMH and progression of geriatric depressive symptoms.


RESULTS
The mean (SD) follow-up duration of the participants was 2.0 (0.8) years. Among APOE ε4 carriers, a severe degree of overall and deep WMH, but not periventricular WMH, predicted progression of geriatric depressive symptoms (overall WMH: coefficient=0.96, p=0.010; deep WMH: 0.87, p=0.016). There were significant interaction between APOE ε4, degree of WMH and time in predicting GDS increase (5df, F=2.28, p=0.046).


CONCLUSIONS
Only subjects seeking medical attention and with follow-up measurements were enrolled in this study. Specific location of WMH and use of antidepressant were uncontrolled.


CONCLUSIONS
Considering biological markers such as degree of WMH and APOE ε4 status may be clinically relevant to predicting progression of geriatric depressive symptoms.
Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
Ki Jung
KJ
Chang
Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea; Memory Impairment Center, Ajou University Hospital, Suwon, Republic of Korea.
Chang Hyung
CH
Hong
Department of Psychiatry, CHA University School of Medicine, CHA Hospital, Bundang, Republic of Korea.
Kang Soo
KS
Lee
Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
Hyun Woong
HW
Roh
Department of Neurology, Inha University college of Medicine, Incheon, Republic of Korea.
Seong Hye
SH
Choi
Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea.
Seong Yoon
SY
Kim
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Duk L
DL
Na
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Sang Won
SW
Seo
Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Do-Kwan
DK
Kim
Department of Biostatstics, Ajou University School of Medicine, Suwon, Republic of Korea.
Dae Ryong
DR
Kang
Department of Biostatstics, Ajou University School of Medicine, Suwon, Republic of Korea.
Jayoun
J
Kim
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea; Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea.
Yunhwan
Y
Lee
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea.
Si Heon
SH
Kim
Health Insurance Policy Research Institute, National Health Insurance Service, Seoul, Republic of Korea.
Joung Hwan
JH
Back
Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
Young Ki
YK
Chung
Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
Ki Young
KY
Lim
Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea.
Jai Sung
JS
Noh
Department of Psychiatry, Yonsei University School of Medicine, Seoul, Republic of Korea.
Byung Hoon
BH
Oh
Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: sjsonpsy@ajou.ac.kr.
Sang Joon
SJ
Son
D000368:Aged; D000369:Aged, 80 and over; D053327:Apolipoprotein E4 / Q000235:genetics*; D003863:Depression / Q000235:genetics* / Q000473:pathology*; D018450:Disease Progression; D058068:Endophenotypes; D005260:Female; D005838:Genotype; D015577:Geriatric Assessment; D006801:Humans; D000067562:Late Onset Disorders / Q000235:genetics / Q000473:pathology; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D012307:Risk Factors; D066127:White Matter / Q000473:pathology*
D053327:Apolipoprotein E4