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Anxiety is related to Alzheimer cerebrospinal fluid markers in subjects with mild cognitive impairment

Published online by Cambridge University Press:  07 September 2012

I. H. G. B. Ramakers ,
F. R. J. Verhey ,
P. Scheltens ,
H. Hampel ,
H. Soininen ,
P. Aalten ,
M. Olde Rikkert ,
M. M. Verbeek ,
L. Spiru  and
K. Blennow
...Show all authors
I. H. G. B. Ramakers*
Affiliation:
Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands
F. R. J. Verhey
Affiliation:
Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands
P. Scheltens
Affiliation:
Department of Neurology, Alzheimer Center, VU Medical Center, Amsterdam, The Netherlands
H. Hampel
Affiliation:
Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University of Frankfurt, Frankfurt am Main, Germany
H. Soininen
Affiliation:
Department of Neurology, University and University Hospital of Kuopio, Kuopio, Finland
P. Aalten
Affiliation:
Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands
M. Olde Rikkert
Affiliation:
Department of Geriatrics, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
M. M. Verbeek
Affiliation:
Department of Neurology and Laboratory Medicine, Alzheimer Center Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
L. Spiru
Affiliation:
‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
K. Blennow
Affiliation:
Clinical Neurochemistry Laboratory, Göteborg University, Sahlgren's University Hospital, Mölndal, Sweden
J. Q. Trojanowski
Affiliation:
Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
L. M. Shaw
Affiliation:
Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
P. J. Visser
Affiliation:
Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands Department of Neurology, Alzheimer Center, VU Medical Center, Amsterdam, The Netherlands
*
*Address for correspondence: I. H. G. B. Ramakers, Ph.D., Maastricht University, Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, PO Box 616, 6200 MD Maastricht, The Netherlands. (Email: [email protected])
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Abstract

Background

Anxiety, apathy and depression are common in subjects with mild cognitive impairment (MCI) and may herald Alzheimer's disease (AD). We investigated whether these symptoms correlated with cerebrospinal fluid (CSF) markers for AD in subjects with MCI.

Method

Subjects with MCI (n=268) were selected from the ‘Development of screening guidelines and criteria for pre-dementia Alzheimer's disease’ (DESCRIPA) and Alzheimer's Disease Neuroimaging Initiative (ADNI) studies. We measured amyloid β(1-42) protein (Aβ42) and total tau (t-tau) in CSF. Neuropsychiatric symptoms were measured with the Neuropsychiatric Inventory.

Results

Depressive symptoms were reported by 55 subjects (21%), anxiety by 35 subjects (13%) and apathy by 49 subjects (18%). The presence of anxiety was associated with abnormal CSF Aβ42 [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.6–3.3] and t-tau (OR 2.6, 95% CI 1.9–3.6) concentrations and with the combination of abnormal concentrations of both Aβ42 and t-tau (OR 3.1, 95% CI 2.0–4.7). The presence of agitation and irritability was associated with abnormal concentrations of Aβ42 (agitation: OR 1.6, 95% CI 1.1–2.3; irritability: OR 2.2, 95% CI 1.5–3.3). Symptoms of depression and apathy were not related to any of the CSF markers.

Conclusions

In subjects with MCI, symptoms of anxiety, agitation and irritability may reflect underlying AD pathology, whereas symptoms of depression and apathy do not.

Keywords

Alzheimer's diseaseanxietyapathybiomarkerscerebrospinal fluiddepressionmild cognitive impairmentneuropsychiatric symptoms
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 5 , May 2013 , pp. 911 - 920
Copyright
Copyright © Cambridge University Press 2012

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