ANXIETY AND DEPRESSION ASSOCIATIONS WITH CORTICAL AMYLOID BURDEN IN COGNITIVELY UNIMPAIRED OLDER ADULTS
- Catriona Lewis, United States of America
Abstract
Aims
To determine the relationship between neuropsychiatric symptoms and beta-amyloid deposition in cognitively unimpaired older adults and to assess mediating effects of either objective or self-perceived cognitive performance.
Methods
Screening data from 4492 cognitively unimpaired adults, age 65-85, enrolled in the Anti-Amyloid Treatment in Asymptomatic Alzheimer Disease (A4) Study were used in this cross-sectional analysis: demographics, Geriatric Depression Scale (GDS), “state” items of the State Trait Anxiety Inventory (STAI), Preclinical Alzheimer’s Cognitive Composite (PACC), Cognitive Function Index (CFI), and beta-amyloid PET SUVR in an Alzheimer’s composite cortical region. We used linear regression to estimate the associations between SUVR and GDS and STAI scores while adjusting for potential confounders. To assess mediation we reran the models while additionally adjusting for CFI or PACC scores.
Results
4342 subjects were included (mean age: 71.3, 59% female), GDS ranged 0-13 (median: 1), and STAI ranged 6-24 (median: 10). Beta-amyloid SUVR was modestly associated with STAI; mean STAI score was estimated to be 0.29 points higher (95% CI: 0.046, 0.526; p-value = 0.019) for each 0.5 point increase in amyloid SUVR. Self-perceived cognitive decline (CFI) attenuated the relationship between STAI and SUVR, while objective cognitive function (PACC) did not. There was no significant relationship between GDS and SUVR (p-value = 0.35).
Conclusions
In cognitively unimpaired older adults with low levels of depression and anxiety, the relationship between beta-amyloid deposition and anxiety was significant, although small. CFI attenuation of this relationship suggests that anxiety may be partly due to perceived cognitive decline resulting from cortical beta-amyloid deposition.