TY - JOUR
T1 - Neuropsychiatric Symptoms and Alzheimer Disease Biomarkers Independently Predict Progression to Incident Cognitive Impairment
AU - Babulal, Ganesh M.
AU - Chen, Ling
AU - Murphy, Samantha A.
AU - Doherty, Jason M.
AU - Johnson, Ann M.
AU - Morris, John C.
N1 - Publisher Copyright:
© 2023 American Association for Geriatric Psychiatry
PY - 2023/12
Y1 - 2023/12
N2 - Objectives: To investigate the effect of neuropsychiatric symptoms and depression symptoms, respectively, and Alzheimer disease (AD) biomarkers (cerebrospinal fluid [CSF] or Positron Emission Tomography [PET] imaging) on the progression to incident cognitive impairment among cognitively normal older adults. Design: Prospective, observation, longitudinal study. Setting: Knight Alzheimer Disease Research Center (ADRC) at Washington University School of Medicine. Participants: Older adults aged 65 and above who participated in AD longitudinal studies (n = 286). Measurements: CSF and PET biomarkers, Clinical Dementia Rating (CDR), Geriatric Depression Scale (GDS), and Neuropsychiatric Inventory Questionnaire (NPI-Q). Results: Participants had an average follow-up of eight years, and 31 progressed from CDR 0 to CDR >0. After adjusting for sex, age, and education in the Cox proportional hazards survival models, neuropsychiatric symptoms as a time-dependent covariate was statistically significant in the three CSF (Aβ42/Aβ40, t-Tau/Aβ42, p-Tau/Aβ42) PET imaging models (HR = 1.33–1.50). The biomarkers were also significant as main effects (HR = 2.00–4.04). Change in depression symptoms was not significant in any models. The interactions between biomarkers and neuropsychiatric symptoms and depression were not statistically significant. Conclusions: Changes in neuropsychiatric symptoms increase the risk of progression to cognitive impairment among healthy, cognitively normal adults, independent of AD biomarkers. Routine assessment of neuropsychiatric symptoms could provide valuable clinical information about cognitive functioning and preclinical disease state.
AB - Objectives: To investigate the effect of neuropsychiatric symptoms and depression symptoms, respectively, and Alzheimer disease (AD) biomarkers (cerebrospinal fluid [CSF] or Positron Emission Tomography [PET] imaging) on the progression to incident cognitive impairment among cognitively normal older adults. Design: Prospective, observation, longitudinal study. Setting: Knight Alzheimer Disease Research Center (ADRC) at Washington University School of Medicine. Participants: Older adults aged 65 and above who participated in AD longitudinal studies (n = 286). Measurements: CSF and PET biomarkers, Clinical Dementia Rating (CDR), Geriatric Depression Scale (GDS), and Neuropsychiatric Inventory Questionnaire (NPI-Q). Results: Participants had an average follow-up of eight years, and 31 progressed from CDR 0 to CDR >0. After adjusting for sex, age, and education in the Cox proportional hazards survival models, neuropsychiatric symptoms as a time-dependent covariate was statistically significant in the three CSF (Aβ42/Aβ40, t-Tau/Aβ42, p-Tau/Aβ42) PET imaging models (HR = 1.33–1.50). The biomarkers were also significant as main effects (HR = 2.00–4.04). Change in depression symptoms was not significant in any models. The interactions between biomarkers and neuropsychiatric symptoms and depression were not statistically significant. Conclusions: Changes in neuropsychiatric symptoms increase the risk of progression to cognitive impairment among healthy, cognitively normal adults, independent of AD biomarkers. Routine assessment of neuropsychiatric symptoms could provide valuable clinical information about cognitive functioning and preclinical disease state.
KW - Biomarkers
KW - amyloid imaging
KW - cerebrospinal fluid
KW - cognitive impairment
KW - depression
KW - neuropsychiatric symptoms
UR - http://www.scopus.com/inward/record.url?scp=85167781940&partnerID=8YFLogxK
U2 - 10.1016/j.jagp.2023.07.012
DO - 10.1016/j.jagp.2023.07.012
M3 - Article
C2 - 37544835
AN - SCOPUS:85167781940
SN - 1064-7481
VL - 31
SP - 1190
EP - 1199
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 12
ER -