Translational Neuroscience and Aging Laboratory, Mayo Clinic, Scottsdale, AZ, USA.
Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.
Transl Psychiatry. 2019 Mar 28;9(1):123. doi: 10.1038/s41398-019-0456-z.
Neuropsychiatric symptoms (NPS) are a risk factor for cognitive impairment and are associated with cortical β-amyloid (Aβ) deposition. We conducted a cross-sectional study derived from the ongoing population-based Mayo Clinic Study of Aging to examine the frequency of NPS among cognitively unimpaired (CU) and mild cognitive impairment (MCI) participants who either have normal (A-) or abnormal (A+) Aβ deposition. We also investigated whether combined presence of MCI and amyloid positivity (MCI/A+) is associated with greater odds of having NPS as compared to CU/A- (defined as reference group). Participants were 1627 CU and MCI individuals aged ≥ 50 years (54% males; median age 73 years). All participants underwent NPS assessment (Neuropsychiatric Inventory Questionnaire (NPI-Q); Beck Depression Inventory II (BDI-II); Beck Anxiety Inventory (BAI)) and C-PiB-PET. Participants with an SUVR > 1.42 were classified as A+. We conducted multivariable logistic regression analyses adjusted for age, sex, education, and APOE ε4 genotype status. The sample included 997 CU/A-, 446 CU/A+, 78 MCI/A-, and 106 MCI/A+ persons. For most NPS, the highest frequency of NPS was found in MCI/A+ and the lowest in CU/A-. The odds ratios of having NPS, depression (BDI ≥ 13), or anxiety (BAI ≥ 8, ≥ 10) were consistently highest for MCI/A+ participants. In conclusion, MCI with Aβ burden of the brain is associated with an increased risk of having NPS as compared to MCI without Aβ burden. This implies that the underlying Alzheimer's disease biology (i.e., cerebral Aβ amyloidosis) may drive both cognitive and psychiatric symptoms.
神经精神症状（NPS）是认知障碍的危险因素，与皮质β-淀粉样蛋白（Aβ）沉积有关。我们进行了一项横断面研究，该研究源自正在进行的基于人群的梅奥诊所衰老研究，以检查认知正常（A-）和轻度认知障碍（MCI）参与者中 NPS 的频率，这些参与者的 Aβ沉积正常（A-）或异常（A+）。我们还调查了 MCI 和淀粉样蛋白阳性（MCI/A+）的合并存在是否与 NPS 的可能性更大相关，与认知正常/淀粉样蛋白阴性（CU/A-；定义为参考组）相比。参与者为≥50 岁的 1627 名认知正常和 MCI 个体（54%为男性；中位年龄 73 岁）。所有参与者均接受了 NPS 评估（神经精神问卷（NPI-Q）；贝克抑郁量表二（BDI-II）；贝克焦虑量表（BAI））和 C-PiB-PET。SUVR>1.42 的参与者被归类为 A+。我们进行了多变量逻辑回归分析，调整了年龄、性别、教育和 APOE ε4 基因型状况。样本包括 997 名 CU/A-、446 名 CU/A+、78 名 MCI/A-和 106 名 MCI/A+个体。对于大多数 NPS，MCI/A+的 NPS 发生率最高，而 CU/A-的 NPS 发生率最低。MCI/A+参与者的 NPS、抑郁（BDI≥13）或焦虑（BAI≥8、≥10）的可能性最高。总之，与无 Aβ 负担的 MCI 相比，大脑 Aβ 负担的 MCI 与 NPS 的风险增加相关。这意味着潜在的阿尔茨海默病生物学（即大脑 Aβ 淀粉样变性）可能同时导致认知和精神症状。
