Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands.
Department of Psychiatry and Behavioral Sciences, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University School of Medicine and Johns Hopkins Bayview, Baltimore, Maryland, USA.
Int J Geriatr Psychiatry. 2021 Jan;36(1):224-234. doi: 10.1002/gps.5418. Epub 2020 Sep 11.
To examine trajectories of depression and apathy over a 5-year follow-up period in (prodromal) Alzheimer's disease (AD), and to relate these trajectories to AD biomarkers.
The trajectories of depression and apathy (measured with the Neuropsychiatric Inventory or its questionnaire) were separately modeled using growth mixture models for two cohorts (National Alzheimer's Coordinating Center, NACC, n = 22 760 and Alzheimer's Disease Neuroimaging Initiative, ADNI, n = 1 733). The trajectories in ADNI were associated with baseline CSF AD biomarkers (Aβ t-tau, and p-tau) using bias-corrected multinomial logistic regression.
Multiple classes were identified, with the largest classes having no symptoms over time. Lower Aβ and higher tau (ie, more AD pathology) was associated with increased probability of depression and apathy over time, compared to classes without symptoms. Lower Aβ (but not tau) was associated with a steep increase of apathy, whereas higher tau (but not Aβ ) was associated with a steep decrease of apathy.
The trajectories of depression and apathy in individuals on the AD spectrum are associated with AD biomarkers.
在（前驱期）阿尔茨海默病（AD）的 5 年随访期间，研究抑郁和淡漠的轨迹，并将这些轨迹与 AD 生物标志物相关联。
使用增长混合模型分别对两个队列（国家阿尔茨海默病协调中心，NACC，n=22760 和阿尔茨海默病神经影像学倡议，ADNI，n=1733）中的抑郁和淡漠（通过神经精神病学问卷测量）轨迹进行建模。ADNI 中的轨迹与基线 CSF AD 生物标志物（Aβ t-tau 和 p-tau）相关联，使用偏置校正的多项逻辑回归。
确定了多个类别，最大的类别随着时间的推移没有症状。与无症状的类别相比，较低的 Aβ 和较高的 tau（即更多的 AD 病理学）与随着时间推移抑郁和淡漠的概率增加相关。较低的 Aβ（但不是 tau）与淡漠的急剧增加相关，而较高的 tau（但不是 Aβ）与淡漠的急剧减少相关。
AD 谱个体的抑郁和淡漠轨迹与 AD 生物标志物相关。
