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Apolipoprotein-E and White-Matter Hyperintensities in Late-Life Depression

Received May 18, 1999; revised November 15, 1999; accepted November 23, 1999. From the UCLA School of Medicine, Department of Psychiatry. Address correspondence to Dr. Lavretsky, UCLA–Neuropsychiatric Institute, Room 37-425, 760 Westwood Pl., Los Angeles CA 90024.

The authors conducted a follow-up study of 16 patients with late-life depression approximately 6 years after their initial assessment to evaluate the relationships between apolipoprotein-E (APO-E) status and white-matter hyperintensities (WMH). Ten patients had WMH at baseline, and four patients demonstrated an increase in WMH size over time. Three of four patients with the APO-E 4 allele demonstrated an increase in WMH over time, and only 1 of 12 patients without an 4 allele had an increase in WMH. Three of four patients with APO-E 4 allele developed a chronic course of major depression at follow-up. Patients with APO-E 4 had a higher number of depressive episodes and lower age at onset. APO-E may be a risk factor for cerebrovascular disease associated with late-life depression and may affect the clinical characteristics and disease course of depression.

Key Words: Dementias • MRI • White-Matter Hyperintensities

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