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

• Published in: Psychological medicine Vol. 43; no. 5; pp. 911 - 920
• Main Authors: Ramakers, I. H. G. B., Verhey, F. R. J., Scheltens, P., Hampel, H., Soininen, H., Aalten, P., Rikkert, M. Olde, Verbeek, M. M., Spiru, L., Blennow, K., Trojanowski, J. Q., Shaw, L. M., Visser, P. J.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.05.2013
• Subjects: Adult and adolescent clinical studies; Aged; Agitation; Alzheimer disease; Alzheimer Disease - cerebrospinal fluid; Alzheimer Disease - psychology; Alzheimer's disease; amyloid beta protein; Amyloid beta-Peptides; Amyloid beta-Peptides - cerebrospinal fluid; Anxiety; Anxiety - cerebrospinal fluid; Anxiety - epidemiology; Anxiety-Depression; Apathy; Biological and medical sciences; biological marker; Biological Markers; Biomarkers; Biomarkers - cerebrospinal fluid; Body fluids; cerebrospinal fluid; Cognition & reasoning; Cognitive Dysfunction - cerebrospinal fluid; Cognitive Dysfunction - epidemiology; Cognitive Dysfunction - psychology; cohort analysis; Cohort Studies; confidence interval; Confidence Intervals; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Depression; Depression - epidemiology; Enzyme-Linked Immunosorbent Assay; Female; Geriatrics; human; Humans; Irritability; Irritable Mood; Irritable Mood - physiology; Male; Medical sciences; mild cognitive impairment; Mood disorders; Neurology; neuropsychiatric symptoms; neuropsychological test; Neuropsychological Tests; Neurosciences; Neurovetenskaper; Odds Ratio; Organic mental disorders. Neuropsychology; Original Articles; Pathology; physiology; psychological aspect; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; risk; Symptoms; tau protein; tau Proteins; tau Proteins - cerebrospinal fluid; anxiety; biomarkers; cerebrospinal fluid; mild cognitive impairment; depression; neuropsychiatric symptoms; Alzheimer's disease; apathy; Mood disorder; Human; Affect affectivity; Nervous system diseases; Cognitive disorder; Alzheimer disease; Neuropsychiatry; Biological marker; Depression; Cerebrospinal fluid; Cerebral disorder; Apathy; Symptomatology; Central nervous system disease; Mental disorder; Degenerative disease; Anxiety
• ISSN: 0033-2917; 1469-8978; 1469-8978
• DOI: 10.1017/S0033291712001870

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