Chronic subjective dizziness among an aging population is associated with amyloid positron emission tomography and neuropsychiatric symptoms

Abstract Objectives. Alzheimer's disease (AD) pathogenesis is widely believed to be driven by the Amyloid-β (Aβ) deposition. A relationship between Aβ deposition and objective measures of vestibular function in cognitively intact older adults with peripheral vestibular disorders had gained previous attention; however, no significant relationship between the two was observed. The aim of this study was to examine the association between chronic subjective dizziness (CSD) and Aβ deposition among older adults who are at risk of AD. Methods. The study included 5707 participants without dementia, enrolled in the Mayo Clinic Study of Ageing with reported dizziness, neuropsychological and cognitive evaluations, and brain imaging at baseline and for every 15-months. Results. A total of 924 ageing adults reported dizziness at baseline. The estimated risk of developing CSD at 10-year was 49%. The CSD group is twice likely to have elevated Aβ deposition (HR = 2.23; p ≤ .001) compared to the control group. After controlling for demographic and other risk factors, CSD was significantly associated with Aβ deposition [HR = 1.8, p ≤ .001]. The status of neuropsychiatric symptoms plays a significant role in this association [HR = 1.0, p ≤ .001]. Conclusion. CSD was associated with Aβ deposition in older adults who are at risk of AD including those without dementia and cognitively unimpaired individuals, and modestly more significant cognitive decline during follow-up. The status of neuropsychiatric symptoms plays a significant role in this association. Screening for and appropriately managing CSD as a risk factor for AD may be warranted.