Andrews Shea J, Ismail Zahinoor, Anstey Kaarin J, Mortby Moyra
Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York.
Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australian Capital Territory, Australia.
Am J Med Genet B Neuropsychiatr Genet. 2018 Dec;177(8):727-735. doi: 10.1002/ajmg.b.32684. Epub 2018 Oct 30.
Mild behavioral impairment (MBI) describes the emergence of later-life neuropsychiatric symptoms (NPS) as an at-risk state for incident cognitive decline and dementia, and for some as a potential manifestation of prodromal dementia. How NPS mechanistically link to the development of mild cognitive impairment and Alzheimer's disease (AD) is not fully understood, with potential mechanisms including shared risk factors related to both NPS and cognitive impairment, or AD pathology promoting NPS. This is the first exploratory study to examine whether AD genetic loci as a genetic risk score (GRS), or individually, are a shared risk factor with MBI. Participants were 1,226 older adults (aged 72-79; 738 males; 763 normal cognition) from the Personality and Total Health Through Life project. MBI was approximated in accordance with Criterion 1 of the ISTAART-AA diagnostic criteria using a transformation algorithm for the neuropsychiatric inventory. A GRS was constructed from 25 AD risk loci. Binomial logistic regression adjusting for age, gender, and education examined the association between GRS and MBI. A higher GRS and APOEε4 were associated with increased likelihood of affective dysregulation. Nominally significant associations were observed between MS4A4A-rs4938933C and MS4A6A-rs610932G with a reduced likelihood of affective dysregulation; ZCWPW1-rs1476679C with a reduced likelihood of social inappropriateness and abnormal perception/thought content; BIN1-rs744373G and EPHA1-rs11767557C with higher likelihood of abnormal perception/thought content; NME8-rs2718058*G with a reduced likelihood of decreased motivation. These preliminary findings suggest a common genetic etiology between MBI and traditionally recognized cognitive problems observed in AD and improve our understanding of the pathophysiological features underlying MBI.
轻度行为损害(MBI)描述了晚年神经精神症状(NPS)的出现,它是认知能力下降和痴呆症的风险状态,对一些人来说,也是前驱性痴呆症的潜在表现。NPS与轻度认知障碍和阿尔茨海默病(AD)发展之间的机制联系尚未完全明确,潜在机制包括与NPS和认知障碍相关的共同风险因素,或AD病理促进NPS。这是第一项探索性研究,旨在检验作为遗传风险评分(GRS)的AD基因位点或单个基因位点是否是MBI的共同风险因素。研究参与者来自“贯穿一生的人格与整体健康”项目,共1226名老年人(年龄72 - 79岁;男性738名;认知正常者763名)。根据ISTAART - AA诊断标准的标准1,使用神经精神症状量表的转换算法来近似评估MBI。从25个AD风险基因座构建GRS。采用二项逻辑回归分析,对年龄、性别和教育程度进行校正,以检验GRS与MBI之间的关联。较高的GRS和APOEε4与情感失调可能性增加相关。在MS4A组(MS4A4A - rs4938933C和MS4A6A - rs610932G)与情感失调可能性降低之间观察到名义上显著的关联;ZCWPW1 - rs1476679C与社交不当和异常感知/思维内容可能性降低相关;BIN1 - rs744373G和EPHA1 - rs11767557C与异常感知/思维内容可能性较高相关;NME8 - rs2718058*G与动机降低可能性降低相关。这些初步研究结果表明MBI与AD中传统认知问题之间存在共同的遗传病因,并增进了我们对MBI潜在病理生理特征的理解。