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Association of the Serotonin Transporter Gene-Linked Polymorphic Region (5-HTTLPR) Genotype With Depression in Elderly Persons After Hip Fracture

Received April 1, 2004; revised May 18, June 9, 2004; accepted June 9, 2004. From the Intervention Research Center for the Study of Late-Life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine (EJL,BGP,FL,TQ,PH,CFR), the Dept. of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine (MCM), the Dept. of Human Genetics, Graduate School of Public Health, University of Pittsburgh (REF), and the Dept. of Occupational Therapy, University of Pittsburgh (ES,JCR). Send correspondence and reprint requests to Dr. Lenze, Western Psychiatric Institute and Clinic, Room E835, 3811 O’Hara Street, Pittsburgh, PA 15213. e-mail: lenzeej{at}upmc.edu
© 2005 American Association for Geriatric Psychiatry

Objective: The authors examined the serotonin transporter gene-linked polymorphic region (5-HTTLPR) as a predictor of major depressive disorder and depressive symptoms after hip fracture, a common stressful medical event. Methods: This was a prospective, observational study of 23 elderly rehabilitation-hospital patients during their inpatient stay. Depressive symptoms were assessed by Hamilton Rating Scale for Depression (Ham-D) and PRIME-MD. Subjects were also genotyped for 5-HTTLPR. Results: Survival analysis showed that genotype significantly predicted time-to-major depressive episode. Subjects with an s allele (genotype s/l or s/s) had significantly higher Ham-D scores over 14 weeks of follow-up than those with the l/l genotype. Conclusion: Depressive symptoms and major depressive disorder in elderly persons after a stressful medical event may be associated with 5-HTTLPR genotype. This finding requires confirmation in a larger sample.

Key Words: Hip Fracture • Depression • Cognitive Impairment • Genetic Factors • Serotonin

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