» Articles » PMID: 38114820

Prediction of Cognitive Decline in Healthy Aging Based on Neuropsychiatric Symptoms and PET-biomarkers of Alzheimer's Disease

Abstract

Neuropsychiatric symptoms (NPS) have been associated with a risk of accelerated cognitive decline or conversion to dementia of the Alzheimer's Disease (AD) type. Moreover, the NPS were also associated with higher AD biomarkers (brain tau and amyloid burden) even in non-demented patients. But the effect of the relationship between NPS and biomarkers on cognitive decline has not yet been studied. This work aims to assess the relationship between longitudinal cognitive changes and NPS, specifically depression and anxiety, in association with AD biomarkers in healthy middle-aged to older participants. The cohort consisted of 101 healthy participants aged 50-70 years, 66 of whom had neuropsychological assessments of memory, executive functions, and global cognition at a 2-year follow-up. At baseline, NPS were assessed using the Beck Depression and Anxiety Inventories while brain tau and amyloid loads were measured using positron emission topography. For tau burden, THK5351 uptake is used as a proxy of tau and neuroinflammation. Participants, declining or remaining stable at follow-up, were categorized into groups for each cognitive domain. Group classification was investigated using binary logistic regressions based on combined AD biomarkers and the two NPS. The results showed that an association between anxiety and prefrontal amyloid burden significantly classified episodic memory decline, while the classification of global cognitive decline involved temporal and occipital amyloid burden but not NPS. Moreover, depression together with prefrontal and hippocampal tau burden were associated with a decline in memory. The classification of participants based on executive decline was related to depression and mainly prefrontal tau burden. These findings suggest that the combination of NPS and brain biomarkers of AD predicts the occurrence of cognitive decline in aging.

Citing Articles

Classification of Parkinson's disease with and without dopaminergic deficiency based on non-motor symptoms and structural neuroimaging.

Ronat L, Rainville P, Monchi O, Hanganu A Neurol Sci. 2025; .

PMID: 39969749 DOI: 10.1007/s10072-025-08045-6.

References
1.
Geda Y, Roberts R, Knopman D, Petersen R, Christianson T, Pankratz V . Prevalence of neuropsychiatric symptoms in mild cognitive impairment and normal cognitive aging: population-based study. Arch Gen Psychiatry. 2008; 65(10):1193-8. PMC: 2575648. DOI: 10.1001/archpsyc.65.10.1193. View

2.
Mortby M, Ismail Z, Anstey K . Prevalence estimates of mild behavioral impairment in a population-based sample of pre-dementia states and cognitively healthy older adults. Int Psychogeriatr. 2017; 30(2):221-232. DOI: 10.1017/S1041610217001909. View

3.
Geda Y, Smith G, Knopman D, Boeve B, Tangalos E, Ivnik R . De novo genesis of neuropsychiatric symptoms in mild cognitive impairment (MCI). Int Psychogeriatr. 2004; 16(1):51-60. DOI: 10.1017/s1041610204000067. View

4.
Rosenberg P, Mielke M, Appleby B, Oh E, Geda Y, Lyketsos C . The association of neuropsychiatric symptoms in MCI with incident dementia and Alzheimer disease. Am J Geriatr Psychiatry. 2013; 21(7):685-95. PMC: 3428504. DOI: 10.1016/j.jagp.2013.01.006. View

5.
Burhanullah M, Tschanz J, Peters M, Leoutsakos J, Matyi J, Lyketsos C . Neuropsychiatric Symptoms as Risk Factors for Cognitive Decline in Clinically Normal Older Adults: The Cache County Study. Am J Geriatr Psychiatry. 2019; 28(1):64-71. PMC: 6874723. DOI: 10.1016/j.jagp.2019.03.023. View