Association of brain amyloidosis with the incidence and frequency of neuropsychiatric symptoms in ADNI: A multisite observational cohort study

Naira Goukasian, Kristy S. Hwang, Tamineh Romero, Jonathan Grotts, Triet M. Do, Jenna R. Groh, Daniel R. Bateman, Liana G. Apostolova

Research output: Contribution to journalArticle

Abstract

Objective To investigate the relationship between amyloid burden and frequency of existing and incidence of new neuropsychiatric symptoms (NPS) in elderly with and without cognitive decline. Methods 275 cognitively normal controls (NC), 100 subjective memory complaint (SMC), 559 mild cognitive impairment (MCI) and 143 Alzheimer's disease dementia subjects from the Alzheimer's Disease Neuroimaging Initiative received (18 F)-florbetapir positron emission tomography (PET) scans. Yearly neuropsychiatric inventory (Neuropsychiatric Inventory (NPI)/NPI-Questionnaire) data were collected from the study partners at each visit. Mean standard uptake volume ratios (SUVR) normalised to whole cerebellum were obtained. Positive amyloid PET scan was defined as mean SUVR ≥1.17. Fisher's exact test was used to compare frequency and incidence between amyloid positive and amyloid negative subjects. Survival analyses were used to estimate of neuropsychiatric symptoms (NPS) between amyloid positive and amyloid negative subjects. Survival analyses were used to estimate hazard ratios for developing the most common NPS by amyloid status. Results No differences in NPS frequency were seen between amyloid positive and amyloid negative NC, SMC, MCI or dementia groups. MCI subjects with amyloid pathology however tended to have greater frequency x severity (FxS) of anxiety, hallucinations, delusions, apathy, disinhibition, irritability, aberrant motor behavior, and appetite, but not agitation, depression, night-time disturbances, or elation. MCI subjects with amyloid pathology were at greater risk for developing apathy, anxiety and agitation over time. Baseline presence of agitation and apathy and new onset agitation, irritability and apathy predicted faster conversion to dementia among MCI subjects. Conclusions Amyloid pathology is associated with greater rate of development of new NPS in MCI. Anxiety and delusions are significant predictors of amyloid pathology. Agitation, irritability and apathy are significant predictors for conversion from MCI to dementia.

Original languageEnglish (US)
Article numbere031947
JournalBMJ open
Volume9
Issue number12
DOIs
StatePublished - Dec 18 2019

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Amyloidosis
Amyloid
Observational Studies
Cohort Studies
Incidence
Brain
Apathy
Pathology
Dementia
Alzheimer Disease
Delusions
Anxiety
Survival Analysis
Equipment and Supplies
Positron-Emission Tomography
Cognitive Dysfunction
Hallucinations
Appetite
Neuroimaging
Cerebellum

Keywords

  • Alzheimer's disease (AD)
  • Alzheimer's Disease Neuroimaging Initiative (ADNI)
  • Amyloidosis
  • Mild Cognitive Impairment (MCI)
  • Neuropsychiatric Symptoms (NPS)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Association of brain amyloidosis with the incidence and frequency of neuropsychiatric symptoms in ADNI : A multisite observational cohort study. / Goukasian, Naira; Hwang, Kristy S.; Romero, Tamineh; Grotts, Jonathan; Do, Triet M.; Groh, Jenna R.; Bateman, Daniel R.; Apostolova, Liana G.

In: BMJ open, Vol. 9, No. 12, e031947, 18.12.2019.

Research output: Contribution to journalArticle

Goukasian, Naira ; Hwang, Kristy S. ; Romero, Tamineh ; Grotts, Jonathan ; Do, Triet M. ; Groh, Jenna R. ; Bateman, Daniel R. ; Apostolova, Liana G. / Association of brain amyloidosis with the incidence and frequency of neuropsychiatric symptoms in ADNI : A multisite observational cohort study. In: BMJ open. 2019 ; Vol. 9, No. 12.
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AU - Goukasian, Naira

AU - Hwang, Kristy S.

AU - Romero, Tamineh

AU - Grotts, Jonathan

AU - Do, Triet M.

AU - Groh, Jenna R.

AU - Bateman, Daniel R.

AU - Apostolova, Liana G.

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AB - Objective To investigate the relationship between amyloid burden and frequency of existing and incidence of new neuropsychiatric symptoms (NPS) in elderly with and without cognitive decline. Methods 275 cognitively normal controls (NC), 100 subjective memory complaint (SMC), 559 mild cognitive impairment (MCI) and 143 Alzheimer's disease dementia subjects from the Alzheimer's Disease Neuroimaging Initiative received (18 F)-florbetapir positron emission tomography (PET) scans. Yearly neuropsychiatric inventory (Neuropsychiatric Inventory (NPI)/NPI-Questionnaire) data were collected from the study partners at each visit. Mean standard uptake volume ratios (SUVR) normalised to whole cerebellum were obtained. Positive amyloid PET scan was defined as mean SUVR ≥1.17. Fisher's exact test was used to compare frequency and incidence between amyloid positive and amyloid negative subjects. Survival analyses were used to estimate of neuropsychiatric symptoms (NPS) between amyloid positive and amyloid negative subjects. Survival analyses were used to estimate hazard ratios for developing the most common NPS by amyloid status. Results No differences in NPS frequency were seen between amyloid positive and amyloid negative NC, SMC, MCI or dementia groups. MCI subjects with amyloid pathology however tended to have greater frequency x severity (FxS) of anxiety, hallucinations, delusions, apathy, disinhibition, irritability, aberrant motor behavior, and appetite, but not agitation, depression, night-time disturbances, or elation. MCI subjects with amyloid pathology were at greater risk for developing apathy, anxiety and agitation over time. Baseline presence of agitation and apathy and new onset agitation, irritability and apathy predicted faster conversion to dementia among MCI subjects. Conclusions Amyloid pathology is associated with greater rate of development of new NPS in MCI. Anxiety and delusions are significant predictors of amyloid pathology. Agitation, irritability and apathy are significant predictors for conversion from MCI to dementia.

KW - Alzheimer's disease (AD)

KW - Alzheimer's Disease Neuroimaging Initiative (ADNI)

KW - Amyloidosis

KW - Mild Cognitive Impairment (MCI)

KW - Neuropsychiatric Symptoms (NPS)

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