Specific Association of Worry With Amyloid-β But Not Tau in Cognitively Unimpaired Older Adults

IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY American Journal of Geriatric Psychiatry Pub Date : 2024-05-04 DOI:10.1016/j.jagp.2024.04.016
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Abstract

Objective

Anxiety disorders and subsyndromal anxiety symptoms are highly prevalent in late life. Recent studies support that anxiety may be a neuropsychiatric symptom during preclinical Alzheimer's disease (AD) and that higher anxiety is associated with more rapid cognitive decline and progression to cognitive impairment. However, the associations of specific anxiety symptoms with AD pathologies and with co-occurring subjective and objective cognitive changes have not yet been established.

Methods

Baseline data from the A4 and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration studies were analyzed. Older adult participants (n = 4,486) underwent assessments of anxiety (State-Trait Anxiety Inventory–6 item version [STAI]), and cerebral amyloid-beta (Aβ; 18F-florbetapir) PET and a subset underwent tau (18F-flortaucipir) PET. Linear regressions estimated associations of Aβ in a cortical composite and tau in the amygdala, entorhinal, and inferior temporal regions with STAI-Total and individual STAI item scores. Models adjusted for age, sex, education, marital status, depression, Apolipoprotein ε4 genotype, and subjective and objective cognition (Cognitive Function Index-participant; Preclinical Alzheimer Cognitive Composite).

Results

Greater Aβ deposition was significantly associated with higher STAI-Worry, adjusting for all covariates, but not with other STAI items or STAI-Total scores. In mediation analyses, the association of Aβ with STAI-Worry was partially mediated by subjective cognition with a stronger direct effect. No associations were found for regional tau deposition with STAI-Total or STAI-Worry score.

Conclusion

Greater worry was associated with Aβ but not tau deposition, independent of subjective and objective cognition in cognitively unimpaired (CU) older adults. These findings implicate worry as an early, specific behavioral marker and a possible therapeutic target in preclinical AD.

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在认知能力未受损的老年人中,忧虑与淀粉样蛋白-β而非 tau 存在特定联系
目的 焦虑症和亚焦虑症状在晚年非常普遍。最近的研究证实,焦虑可能是阿尔茨海默病(AD)临床前期的一种神经精神症状,焦虑程度越高,认知能力下降越快,并发展为认知障碍。然而,特定焦虑症状与阿尔茨海默病病理变化以及同时出现的主观和客观认知变化之间的关系尚未确定。方法分析了淀粉样蛋白风险和神经退行性变研究 A4 和纵向评估的基线数据。老年参与者(n = 4,486)接受了焦虑评估(状态-特质焦虑量表-6项版 [STAI])和脑淀粉样蛋白-β(Aβ;18F-florbetapir)PET,部分参与者接受了tau(18F-flortaucipir)PET。线性回归估算了皮层复合 Aβ 和杏仁核、内黑质和下颞区 tau 与 STAI 总分和单个 STAI 项目得分的关系。结果在调整了所有协变量后,Aβ沉积较多与STAI-Worry较高显著相关,但与其他STAI项目或STAI-总分无关。在中介分析中,Aβ与STAI-Worry的关联部分由主观认知中介,直接效应更强。结论在认知功能未受损(CU)的老年人中,更多的担忧与 Aβ 相关,但与 tau 沉积无关,与主观和客观认知无关。这些发现表明,忧虑是一种早期的特异性行为标记,也是临床前注意力缺失症的可能治疗目标。
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来源期刊
CiteScore
13.00
自引率
4.20%
发文量
381
审稿时长
26 days
期刊介绍: The American Journal of Geriatric Psychiatry is the leading source of information in the rapidly evolving field of geriatric psychiatry. This esteemed journal features peer-reviewed articles covering topics such as the diagnosis and classification of psychiatric disorders in older adults, epidemiological and biological correlates of mental health in the elderly, and psychopharmacology and other somatic treatments. Published twelve times a year, the journal serves as an authoritative resource for professionals in the field.
期刊最新文献
Editorial Board Table of Contents In This Issue Information for Subscribers Suicidal Behavior in Older Adults With Cognitive Impairment.
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