Increasing Depression Symptoms in Older Adults Associated With Amyloid Accumulation

Increasing depression symptoms in older adults were associated with early amyloid accumulation in regions responsible for emotional control, and may foretell later Alzheimer Disease (AD) development. Results from the cohort study were published in JAMA Network Open.

“These findings…have implications for recognizing individuals in preclinical Alzheimer disease stages who may be candidates for disease-modifying treatments and for considering depression treatment to prevent dementia,” wrote Catherine E. Munro, PhD, Harvard Medical School, and co-authors.

Authors utilized a sample of longitudinal data from the Harvard Aging Brain Study, during which older adults were assessed annually for depression, cognition, and cortical amyloid positron emission tomography (PET) imagining. Included in the present cohort study were 154 older adults who were “cognitively unimpaired and had mild or no depressive symptoms at baseline.”

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To evaluate whether increasing depression symptoms were associated with amyloid accumulation, researchers administered the Geriatric Depression Scale (GDS), the Preclinical Alzheimer Cognitive Composite-5 (PAAC), and an ongoing measure of cerebral amyloid in the patients under study. Linear mixed-effects models were used to determine associations between longitudinal GDS scores, regional amyloid slopes, and PAAC slopes.

In the sample population (94 [61%] female; mean [SD] age, 72.6 [6.4] years; mean (SD) education, 15.9 [3.1] years), increasing slopes for amyloid in the bilateral medial orbitofrontal cortex (mOFC), isthmus cingulate cortex (IC), and middle frontal cortex (MFC) were associated with increased GDS scores (mOFC: β = 11.07 [95% CI, 5.26-16.87]; t = 3.74 [SE, 2.96]; P = .004; IC: β = 12.83 [95% CI, 5.68-19.98]; t = 3.51 [SE, 3.65]; P = .004; MFC: β = 9.22 [95% CI, 2.25-16.20]; t = 2.59 [SE, 3.56]; P = .03). PACC slopes did not affect the significance of the associations found.

“These results shed light on the neurobiology of depressive symptoms in older individuals and underscore the importance of monitoring for elevated mood symptoms early in AD,” the authors concluded.

Reference

Munro CE, Farrell M, Hanseeuw B, et al. Change in depressive symptoms and longitudinal regional amyloid accumulation in unimpaired older adults. JAMA Netw Open. 2024;7(8):e2427248. doi:10.1001/jamanetworkopen.2024.27248