Department of Geriatrics, Paracelsus Medical University, Salzburg, Austria.
Department of Quantitative Health Sciences, Mayo Clinic Rochester, Rochester, Minnesota, USA.
Alzheimers Dement. 2022 Oct;18(10):1824-1831. doi: 10.1002/alz.12504. Epub 2021 Dec 8.
We investigated the longitudinal relationship between cortical amyloid deposition, anxiety, and depression and the risk of incident mild cognitive impairment (MCI).
We followed 1440 community-dwelling, cognitively unimpaired individuals aged ≥ 50 years for a median of 5.5 years. Clinical anxiety and depression were assessed using Beck Anxiety and Depression Inventories (BAI, BDI-II). Cortical amyloid beta (Aβ) was measured by Pittsburgh compound B positron emission tomography (PiB-PET) and elevated deposition (PiB+) was defined as standardized uptake value ratio ≥ 1.48. We calculated Cox proportional hazards models with age as the time scale, adjusted for sex, education, and medical comorbidity.
Cortical Aβ deposition (PiB+) independent of anxiety (BAI ≥ 10) or depression (BDI-II ≥ 13) increased the risk of MCI. There was a significant additive interaction between PiB+ and anxiety (joint effect hazard ratio 6.77; 95% confidence interval 3.58-12.79; P = .031) that is, being PiB+ and having anxiety further amplified the risk of MCI.
Anxiety modified the association between PiB+ and incident MCI.
我们研究了皮质淀粉样蛋白沉积、焦虑和抑郁与轻度认知障碍（MCI）发病风险之间的纵向关系。
我们对 1440 名年龄≥50 岁、认知正常、居住在社区的个体进行了中位时间为 5.5 年的随访。使用贝克焦虑和抑郁量表（BAI、BDI-II）评估临床焦虑和抑郁。采用匹兹堡化合物 B 正电子发射断层扫描（PiB-PET）测量皮质β淀粉样蛋白（Aβ），将标准化摄取值比（SUVR）≥1.48 定义为沉积升高（PiB+）。我们使用 Cox 比例风险模型，以年龄为时间尺度，调整性别、教育程度和合并症。
皮质 Aβ 沉积（PiB+）与焦虑（BAI≥10）或抑郁（BDI-II≥13）无关，增加了 MCI 的发病风险。PiB+与焦虑之间存在显著的相加交互作用（联合效应风险比 6.77；95%置信区间 3.58-12.79；P=0.031），即 PiB+和焦虑进一步放大了 MCI 的发病风险。
焦虑改变了 PiB+与新发 MCI 之间的关联。
