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The Relationship Between Cerebrospinal Fluid Biomarkers and Depression in Elderly Women

From the Institute of Neuroscience and Physiology, Section for Psychiatry and Neurochemistry, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden (PG, IS, MW, KB, SP, LR, DG); and the Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, WI (DG).

Objective: Cerebrospinal fluid (CSF) biomarkers including the 42 amino-acid form of ß-amyloid (Aß42), total tau protein (T-tau), and the CSF/serum albumin ratio are markers of brain pathology and metabolism. Aß42 and T-tau are sometimes used to discriminate geriatric depression from mild forms of Alzheimer disease (AD) in clinical studies. However, studies focusing on the relationship between these CSF biomarkers and geriatric depression are lacking.

Methods: This was a cross-sectional study with a population-based sample of 84 nondemented elderly women in Sweden. Measurements included neuropsychiatric, physical, and lumbar puncture examinations, with Diagnostic and Statistical Manual of Mental Disorders, Third Revision–based depression diagnoses and measurement of CSF levels of Aß42, T-tau, albumin, and serum albumin.

Results: Fourteen women (mean age: 72.6 years) had any depression (11 with major depressive disorder [MDD]). Compared to women without depression, women with MDD had higher levels of Aß42 and the CSF/serum albumin ratio. The CSF/serum albumin ratio was also higher in women with any depression. No differences in T-tau were observed; however, T-tau increased with age.

Conclusion: Higher levels of CSF Aß42 were observed among elderly depressed women, in contrast to lower levels usually observed in AD, indicating potential neuropathological differences between the two disorders. Higher CSF/serum albumin ratios observed in depressed women point to potential vascular processes.

Key Words: Depression • beta amyloid • tau • albumin ratio • cerebrospinal fluid • population-based