| Co-Investigator(Kenkyū-buntansha) |
OTSUKA Mieko Jichi Medical School, Omiya Medical Center, Department of Neurology, Lecturer, M, 医学部, 講師 (30194210)
UEKI Akira Jichi Medical School, Omiya Medical Center, Department of Neurology, Associate P, 医学部, 助教授 (90112622)
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| Research Abstract |
PURPOSE : Depressive state in elderly is known to be psychiatric manifestation of dementia such as Alzheimer's disease (AD) and vascular dementia. Recentrly, epsilon4 allele of apolipoprotein E (apoE-epsilon4) has been established to be a risk factor of AD.To see whether any psychiatric monifestations are linked with AD via epsilon4, we examined apoE phenotypes in elderly patients who manifested psychosis without cognitive impairment and compared them with AD and controls. SUBJECTS and METHODS : Subjects were consisted of 114 Psychiatric patients, 80 AD,129 controls. Psychiatric patients were categorized according to the classification of DSMIV ; Mood Disorders (MO,N=26), Anxiety Disorders (AN,N=25), Somatoform Disorders (SO,N=35), Dissociative Disorders (DI,N=4), Sleep Disorders (SL,N=4), Psychological Factors Affecting Medical Condition (PS,N=8), Other Conditions (OT,N=9), and Asymptomatic Cerebral Infarctions (CI,N=3). Depressive state was assessed using Hamilton Self Rating Depress
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ion Scale. ApoE was phentyped using a commercial kit (Phenotyping ApoE IEF Kit, Joko, Tokyo). RESULTS : The ratio of epsilon4-carriers in AD was 0.538, which was significantly higher than that in controls (p=0.0001).Among psychiatric patients, the ratio of epsilon4-carriers was significantly elevated only in the category of MO (0.385, p=0.0437). Other categories did not differ significantly compared with controls ; AN (0.200), SO (0.114), DI (0.000), SL (0.000), PS (0.000), OT (0.111), CI (0.000). No patients became dementia in the observation period of one year and 4 months.DISCUSSION : Among various psychiatirc categories in elderly, depressive state is unique for its high frequency of epsilon4 which is known to be a major risk factor of AD.These results show that the depressive state might be associated with AD via epsilon4. Although those epsilon4-carriers manifesting depressive state will become dementia in future is not clear at present, the combination of apoE test and depression in elderly will be of help for an early diagnosis of AD. Less
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