Myuri Ruthirakuhan1, Nathan Herrmann2, Danielle Vieira3, Damien Gallagher4, Krista L Lanctôt5. 1. Hurvitz Brain Sciences Program (MR, NH, DV, KLL), Sunnybrook Research Institute, Toronto; Departments of Pharmacology and Toxicology (MR, KLL), and Psychiatry (NH, DG, KLL), University of Toronto, Toronto. 2. Hurvitz Brain Sciences Program (MR, NH, DV, KLL), Sunnybrook Research Institute, Toronto; Departments of Pharmacology and Toxicology (MR, KLL), and Psychiatry (NH, DG, KLL), University of Toronto, Toronto; Department of Psychiatry (NH, DG), Sunnybrook Health Sciences Centre, Toronto. 3. Hurvitz Brain Sciences Program (MR, NH, DV, KLL), Sunnybrook Research Institute, Toronto. 4. Departments of Pharmacology and Toxicology (MR, KLL), and Psychiatry (NH, DG, KLL), University of Toronto, Toronto; Department of Psychiatry (NH, DG), Sunnybrook Health Sciences Centre, Toronto. 5. Hurvitz Brain Sciences Program (MR, NH, DV, KLL), Sunnybrook Research Institute, Toronto; Departments of Pharmacology and Toxicology (MR, KLL), and Psychiatry (NH, DG, KLL), University of Toronto, Toronto. Electronic address: krista.lanctot@sunnybrook.ca.
Abstract
OBJECTIVE: Apathy and depression have each been associated with an increased risk of conversion from mild cognitive impairment (MCI) to Alzheimer disease (AD).These symptoms often co-occur and the contribution of each to risk of AD is not clear. METHODS: National Alzheimer's Coordinating Center participants diagnosed with MCI at baseline and followed until development of AD or loss to follow-up (n = 4,932) were included. The risks of developing AD in MCI patients with neuropsychiatric symptoms (NPS) (apathy only, depression only, or both) were compared to that in those without NPS in a multivariate Cox regression survival analysis adjusting for baseline cognitive impairment, years of smoking, antidepressant use, and AD medication use. RESULTS: Thirty-seven percent (N = 1713) of MCI patients developed AD (median follow-up 23 months). MCI patients with both apathy and depression had the greatest risk (hazard ratio [HR] = 1.37; 95% confidence interval [CI]: 1.17-1.61; p < 0.0001; Wald χ2 = 14.70; df = 1). Those with apathy only also had a greater risk (HR = 1.24; 95% CI: 1.05-1.47; p = 0.01; Wald χ2 = 6.22; df = 1), but not those with depression only (HR = 1.08; 95% CI: 0.95-1.22; p=0.25; Wald χ2 = 1.30; df = 1). Post-hoc analyses suggested depression may exacerbate cognitive decline in MCI patients with apathy (odds ratio = 0.70; 95% CI 0.52-0.95; p = 0.02; Wald χ2 = 5.28; df = 1), compared to those without apathy. CONCLUSION: MCI patients with apathy alone or both apathy and depression are at a greater risk of developing AD compared to those with no NPS. Interventions targeting apathy and depression may reduce risk of AD.
OBJECTIVE:Apathy and depression have each been associated with an increased risk of conversion from mild cognitive impairment (MCI) to Alzheimer disease (AD).These symptoms often co-occur and the contribution of each to risk of AD is not clear. METHODS: National Alzheimer's Coordinating Centerparticipants diagnosed with MCI at baseline and followed until development of AD or loss to follow-up (n = 4,932) were included. The risks of developing AD in MCI patients with neuropsychiatric symptoms (NPS) (apathy only, depression only, or both) were compared to that in those without NPS in a multivariate Cox regression survival analysis adjusting for baseline cognitive impairment, years of smoking, antidepressant use, and AD medication use. RESULTS: Thirty-seven percent (N = 1713) of MCI patients developed AD (median follow-up 23 months). MCI patients with both apathy and depression had the greatest risk (hazard ratio [HR] = 1.37; 95% confidence interval [CI]: 1.17-1.61; p < 0.0001; Wald χ2 = 14.70; df = 1). Those with apathy only also had a greater risk (HR = 1.24; 95% CI: 1.05-1.47; p = 0.01; Wald χ2 = 6.22; df = 1), but not those with depression only (HR = 1.08; 95% CI: 0.95-1.22; p=0.25; Wald χ2 = 1.30; df = 1). Post-hoc analyses suggested depression may exacerbate cognitive decline in MCI patients with apathy (odds ratio = 0.70; 95% CI 0.52-0.95; p = 0.02; Wald χ2 = 5.28; df = 1), compared to those without apathy. CONCLUSION: MCI patients with apathy alone or both apathy and depression are at a greater risk of developing AD compared to those with no NPS. Interventions targeting apathy and depression may reduce risk of AD.
Authors: Liana G Apostolova; Gohar G Akopyan; Negar Partiali; Calen A Steiner; Rebecca A Dutton; Kiralee M Hayashi; Ivo D Dinov; Arthur W Toga; Jeffrey L Cummings; Paul M Thompson Journal: Dement Geriatr Cogn Disord Date: 2007-06-14 Impact factor: 2.959
Authors: Constantine G Lyketsos; Oscar Lopez; Beverly Jones; Annette L Fitzpatrick; John Breitner; Steven DeKosky Journal: JAMA Date: 2002-09-25 Impact factor: 56.272
Authors: Nathan Herrmann; Lana S Rothenburg; Sandra E Black; Michelle Ryan; Barbara A Liu; Usoa E Busto; Krista L Lanctôt Journal: J Clin Psychopharmacol Date: 2008-06 Impact factor: 3.153
Authors: Philippe Robert; Claire Albrengues; Roxane Fabre; Alexandre Derreumaux; Marie Pierre Pancrazi; Isabelle Luporsi; Bruno Dubois; Stéphane Epelbaum; Grégoire Mercier; Pierre Foulon; François Bremond; Valeria Manera Journal: Alzheimers Dement (N Y) Date: 2021-05-11
Authors: Radia Zeghari; Alexandra König; Rachid Guerchouche; Garima Sharma; Jyoti Joshi; Roxane Fabre; Philippe Robert; Valeria Manera Journal: JMIR Form Res Date: 2021-03-31
Authors: David S Miller; Philippe Robert; Larry Ereshefsky; Lawrence Adler; Daniel Bateman; Jeff Cummings; Steven T DeKosky; Corinne E Fischer; Masud Husain; Zahinoor Ismail; Judith Jaeger; Alan J Lerner; Abby Li; Constantine G Lyketsos; Valeria Manera; Jacobo Mintzer; Hans J Moebius; Moyra Mortby; Didier Meulien; Stephane Pollentier; Anton Porsteinsson; Jill Rasmussen; Paul B Rosenberg; Myuri T Ruthirakuhan; Mary Sano; Carla Zucchero Sarracini; Krista L Lanctôt Journal: Alzheimers Dement Date: 2021-05-05 Impact factor: 16.655
Authors: A Zarina Kraal; Lauren Massimo; Evan Fletcher; Carmen I Carrión; Luis D Medina; Dan Mungas; Brandon E Gavett; Sarah Tomazewski Farias Journal: Neuropsychology Date: 2021-01 Impact factor: 3.295