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Background: Depression is a common mental disorder, characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration, Over 20% of adults aged 60 and over suffer from a mental or neurological disorder (excluding headache disorders) and 6.6% of all disability (disability adjusted life years-DALYs) among over 60s is attributed to neurological and mental disorders. The most common neuropsychiatric disorders in this age group are dementia and depression. (World Health Organization, [WHO], 2012).
Depression is both under diagnosed and undertreated in primary care settings. Symptoms of depression in older adults are often overlooked and untreated because they coincide with other late life problems. (Espinosa, et. Al. 2007). Depression also increases the perception of poor health, the utilization of medical services and health care costs. Older adults with depressive symptoms have poorer functioning compared to those with chronic medical conditions such as lung disease, hypertension or diabetes. For this reason is important to research and develop new options to contribute for diagnostic and prevention in older adults. (WHO, 2012).
Recent efforts have been done to understand the biological basis of susceptibility to depression. Investigations have demonstrate serotonin play important rol to modulate neural activity and a wide range of neuropsychological processes, even drugs that target serotonin receptors are used widely in psychiatry and neurology. It is widely accepted that abnormal serotonergic function is implicated in the onset and course of depressive disorders.( Alenina, Klempin, 2014)
Previous research revealed a robust genetic component in depressive disorders with heritability estimates between 33 and 42 %.Recent attempts to understand the biological bases of depression vulnerability have focused on both genetic and neural risk factors. One of the most commonly studied genetic polymorphisms is the serotonin transporter-linked polymorphic region (5-HTTLPR). The short (S) allele of the 5-HTTLPR is associated with several psychiatric conditions, perhaps most notably depression. (Gaoa et al. 2014; Marina Mitjans, Bárbara Arias. 2012)
Purpose: To identify whether there are genetic changes that can cause depression and if there are genetic markers that can be used to detect these changes.
Methods:
This study will be evaluated in the elderly population of Saltillo Coahuila city, between the months of January to December 2015. Descriptive comparative correlational design with two different groups: depression group and non-depression group. Depression group will be conformed of pacient using the center for epidemiological studies-depression scale (CESD). Total summary scores range from 0 to 60, with clinical levels of depressive symptomatology being associated with scores of 16 or higher. The sample size will be estimated using the nQuery Advisor 7.0 software; level of confidence 90%, margin of error 5%, and a correlation of .35. Written informed consent will be obtained in accordance with the Hospital Universitario “Dr. Gonzalo Valdez Valdez”.
Each participant will provided peripheral blood samples. Genomic deoxyribonucleic acid (DNA) will be prepared from lymphocytes cells using the Qiagen QIAamp® Blood Mini Kit (Qiagen, Inc, Valencia, California). Polymerase chain reaction (PCR) will be used to amplifity the serotonin transporter promoter region (5-HTTLPR). Forward (5′-ATGCCAGCACCTAAC CCC TAA TGT-3′) and reverse (5′-GGACC GCA AGG TGG GCG GGA-3′) primers, these primers amplify a 419 base pair fragment for the 16-repeat L allele and a 375 base pair fragment for the 14-repeat S allele (Michaelovsky et al. 1999).
First, in order to evaluate the hypothesis of differential associations between depressive symptoms and polymorphism genotype, a multiple regression analysis with genotype will be realize. Tests for behavioral differences between groups on age, personality, education level, economic status and gender will be done using independent sample t-tests.
Results:
The results of two groups will be compared. Descriptive statistics, comparison of means and correlation analysis will be used.
Conclusion:
We will discuss the possible association between depression and the serotonin transporter promoter region in the elderly population of Saltillo Coahuila city, Mexico based on the scientific evidence available in the advanced nursing practice and their implications in positive health outcomes in Mexican older adults.