Is later-life depression a risk factor for Alzheimer’s disease or a prodromal symptom: a study using post-mortem human brain tissue?

Abstract Background Depression and dementia are both common diseases. Although new cases of depression are more common in younger adults, there is a second peak at the age of 50 years suggesting a different pathological process. Late-life depression (LLD) is associated with dementia. However, it rem...

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Main Authors: Lindsey I. Sinclair, Asher Mohr, Mizuki Morisaki, Martin Edmondson, Selina Chan, A. Bone-Connaughton, Gustavo Turecki, Seth Love
Format: Article
Language:English
Published: BMC 2023-09-01
Series:Alzheimer’s Research & Therapy
Subjects:
Online Access:https://doi.org/10.1186/s13195-023-01299-2
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author Lindsey I. Sinclair
Asher Mohr
Mizuki Morisaki
Martin Edmondson
Selina Chan
A. Bone-Connaughton
Gustavo Turecki
Seth Love
author_facet Lindsey I. Sinclair
Asher Mohr
Mizuki Morisaki
Martin Edmondson
Selina Chan
A. Bone-Connaughton
Gustavo Turecki
Seth Love
author_sort Lindsey I. Sinclair
collection DOAJ
description Abstract Background Depression and dementia are both common diseases. Although new cases of depression are more common in younger adults, there is a second peak at the age of 50 years suggesting a different pathological process. Late-life depression (LLD) is associated with dementia. However, it remains unclear whether depression represents a dementia prodrome or is a true risk factor for its development. LLD is thought to have a vascular component and this may be a possible link between depression and dementia. We hypothesised that later-life depression is a prodromal manifestation of dementia and would therefore be associated with more AD, and/or ischaemic brain abnormalities that are present in earlier-life depression or in age- and sex-matched controls. Methods We assessed post-mortem orbitofrontal cortex and dorsolateral pre-frontal cortex from 145 individuals in 4 groups: 28 18–50-year-olds with depression, 30 older individuals (ages 51–90) with depression, 28 with early AD (Braak tangle stages III–IV) and 57 matched controls (17 early-life, 42 later-life). Levels of Aβ, phospho-tau and α-synuclein were assessed by immunohistochemistry and ELISA. To quantify chronic ischaemia, VEGF, MAG and PLP1 were measured by ELISA. To assess pericyte damage, PDGFRB was measured by ELISA. For blood–brain barrier leakiness, JAM-A, claudin 5 and fibrinogen were measured by ELISA. To quantity endothelial activation, the ratio of ICAM1:collagen IV was assessed by immunohistochemistry. Results There was no evidence of chronic cerebral hypoperfusion or increased Aβ/tau in either depression group. There was also no indication of pericyte damage, increased blood–brain barrier leakiness or endothelial activation in the OFC or DLPFC in the depression groups. Conclusions Contrary to some previous findings, we have not found evidence of impaired vascular function or increased Aβ in LLD. Our study had a relatively small sample size and limitations in the availability of clinical data. These results suggest that depression is a risk factor for dementia rather than an early manifestation of AD or a consequence of cerebral vascular insufficiency.
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spelling doaj.art-b0fa5f3bd5544a20aeaed24ceb466cd92024-03-05T17:54:17ZengBMCAlzheimer’s Research & Therapy1758-91932023-09-0115111510.1186/s13195-023-01299-2Is later-life depression a risk factor for Alzheimer’s disease or a prodromal symptom: a study using post-mortem human brain tissue?Lindsey I. Sinclair0Asher Mohr1Mizuki Morisaki2Martin Edmondson3Selina Chan4A. Bone-Connaughton5Gustavo Turecki6Seth Love7Dementia Research Group, Faculty of Health Sciences, University of Bristol, Southmead HospitalDementia Research Group, Faculty of Health Sciences, University of Bristol, Southmead HospitalDementia Research Group, Faculty of Health Sciences, University of Bristol, Southmead HospitalDementia Research Group, Faculty of Health Sciences, University of Bristol, Southmead HospitalDementia Research Group, Faculty of Health Sciences, University of Bristol, Southmead HospitalDementia Research Group, Faculty of Health Sciences, University of Bristol, Southmead HospitalDepartment of Life Sciences, Warwick UniversityDementia Research Group, Faculty of Health Sciences, University of Bristol, Southmead HospitalAbstract Background Depression and dementia are both common diseases. Although new cases of depression are more common in younger adults, there is a second peak at the age of 50 years suggesting a different pathological process. Late-life depression (LLD) is associated with dementia. However, it remains unclear whether depression represents a dementia prodrome or is a true risk factor for its development. LLD is thought to have a vascular component and this may be a possible link between depression and dementia. We hypothesised that later-life depression is a prodromal manifestation of dementia and would therefore be associated with more AD, and/or ischaemic brain abnormalities that are present in earlier-life depression or in age- and sex-matched controls. Methods We assessed post-mortem orbitofrontal cortex and dorsolateral pre-frontal cortex from 145 individuals in 4 groups: 28 18–50-year-olds with depression, 30 older individuals (ages 51–90) with depression, 28 with early AD (Braak tangle stages III–IV) and 57 matched controls (17 early-life, 42 later-life). Levels of Aβ, phospho-tau and α-synuclein were assessed by immunohistochemistry and ELISA. To quantify chronic ischaemia, VEGF, MAG and PLP1 were measured by ELISA. To assess pericyte damage, PDGFRB was measured by ELISA. For blood–brain barrier leakiness, JAM-A, claudin 5 and fibrinogen were measured by ELISA. To quantity endothelial activation, the ratio of ICAM1:collagen IV was assessed by immunohistochemistry. Results There was no evidence of chronic cerebral hypoperfusion or increased Aβ/tau in either depression group. There was also no indication of pericyte damage, increased blood–brain barrier leakiness or endothelial activation in the OFC or DLPFC in the depression groups. Conclusions Contrary to some previous findings, we have not found evidence of impaired vascular function or increased Aβ in LLD. Our study had a relatively small sample size and limitations in the availability of clinical data. These results suggest that depression is a risk factor for dementia rather than an early manifestation of AD or a consequence of cerebral vascular insufficiency.https://doi.org/10.1186/s13195-023-01299-2Depressive disorderAlzheimer’s diseaseAmyloidTauBlood–brain barrierVascular depression
spellingShingle Lindsey I. Sinclair
Asher Mohr
Mizuki Morisaki
Martin Edmondson
Selina Chan
A. Bone-Connaughton
Gustavo Turecki
Seth Love
Is later-life depression a risk factor for Alzheimer’s disease or a prodromal symptom: a study using post-mortem human brain tissue?
Alzheimer’s Research & Therapy
Depressive disorder
Alzheimer’s disease
Amyloid
Tau
Blood–brain barrier
Vascular depression
title Is later-life depression a risk factor for Alzheimer’s disease or a prodromal symptom: a study using post-mortem human brain tissue?
title_full Is later-life depression a risk factor for Alzheimer’s disease or a prodromal symptom: a study using post-mortem human brain tissue?
title_fullStr Is later-life depression a risk factor for Alzheimer’s disease or a prodromal symptom: a study using post-mortem human brain tissue?
title_full_unstemmed Is later-life depression a risk factor for Alzheimer’s disease or a prodromal symptom: a study using post-mortem human brain tissue?
title_short Is later-life depression a risk factor for Alzheimer’s disease or a prodromal symptom: a study using post-mortem human brain tissue?
title_sort is later life depression a risk factor for alzheimer s disease or a prodromal symptom a study using post mortem human brain tissue
topic Depressive disorder
Alzheimer’s disease
Amyloid
Tau
Blood–brain barrier
Vascular depression
url https://doi.org/10.1186/s13195-023-01299-2
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