Background: Depression may increase the risk of developing Alzheimer's disease (AD). Recent large cohort studies have also shown that a low plasma amyloid b (Ab)-42 level combined with a high Ab40 level increases the risk of developing AD, suggesting plasma Ab42/40 ratio as useful for identifying risk of developing mild cognitive impairment and AD. Although several studies have examined Ab levels in the peripheral blood of elderly individuals with depression, results have been inconsistent. Furthermore, no results have been described for younger depression. Methods: Serum Ab40, Ab42 level and Ab40/42 ratio were evaluated using enzyme-linked immunosorbent assay in 60 patients with major depressive disorder (MDD) and 60 healthy controls. The results were analyzed in two age groups (young, <60 years; elderly, Ն60 years). Results: Serum Ab40 level was significantly higher in young MDD patients compared to young controls (P < 0.001), but it was not significantly deferent in the elderly group. Serum Ab42 level did not differ significantly in both young and elderly groups. Ab40/42 ratio was significantly higher in both young (P < 0.001) and elderly (P < 0.001) patients with MDD compared to controls. Conclusions: Serum Ab40/42 ratio was significantly higher in MDD patients than in controls, and this difference was seen for both elderly and young subjects. This may suggest that even young subjects with MDD undergo pathological changes in the very early stage of amyloid deposition.