Department of Neurology (JEB, ZY, KM, KVP, REA, PV, DMR, YTQ, KAJ, RAS, GAM, H-SY), Massachusetts General Hospital, Boston, MA.
Washington University School of Medicine in St. Louis (ZK), St. Louis, MO.
Am J Geriatr Psychiatry. 2024 Aug;32(8):909-919. doi: 10.1016/j.jagp.2024.01.020. Epub 2024 Jan 28.
We examined relationships between apathy (self and study-partner-reported) and markers of Alzheimer's disease (AD) in older adults.
The study utilized a well-characterized sample of participants from the Harvard Aging Brain Study (HABS), a longitudinal cohort study. Participants were cognitively unimpaired without clinically significant neuropsychiatric symptoms at HABS baseline. The dependent variables, apathy evaluation scale-self (AES-S) and informant (AES-I), were administered cross-sectionally between years 6-9 and compared to the independent variables, amyloid and tau PET neuroimaging, from the same year.
Community-dwelling participants assessed at research visits in an academic medical center.
Participants (n = 170) completed assessments within 1.5 years of their neuroimaging visit. At the time of apathy assessment, N = 156 were cognitively unimpaired and 14 had progressed to mild cognitive impairment (n = 8) or dementia (n = 6).
We utilized linear regression models to assess cross-sectional associations of AES-S and AES-I with AD PET imaging measures (beta-amyloid (Pittsburgh Compound B) and tau (Flortaucipir)), covarying for age, sex, education, and the time between PET scan-apathy assessment.
AES-I was significantly associated with beta-amyloid and temporal lobe tau, and the associations were retained after further adjusting for depressive symptoms. The associations between AES-S and AD biomarkers were not significant. In an exploratory subgroup analysis of cognitively unimpaired individuals with elevated Aβ, we observed an association between AES-I and inferior temporal tau.
Study-partner-reported, but not self-reported, apathy in older adults is associated with AD pathology, and we observed this relationship starting from the preclinical stage. Our findings highlight the importance of collateral information in capturing AD-related apathy.
我们研究了老年人的冷漠（自我报告和研究伙伴报告）与阿尔茨海默病（AD）标志物之间的关系。
本研究利用了哈佛衰老大脑研究（HABS）中参与者的一个特征良好的样本，这是一个纵向队列研究。参与者在 HABS 基线时认知无障碍，且无明显的神经精神症状。依赖变量为自我（AES-S）和知情者（AES-I）的冷漠评估量表，并在第 6 年至第 9 年期间进行横断面比较，而独立变量则为同年的淀粉样蛋白和 tau PET 神经影像学。
在学术医疗中心的研究访问中评估的社区居住参与者。
170 名参与者在神经影像学就诊后的 1.5 年内完成了评估。在进行冷漠评估时，156 名参与者认知无障碍，14 名参与者进展为轻度认知障碍（8 名）或痴呆（6 名）。
我们利用线性回归模型来评估 AES-S 和 AES-I 与 AD PET 成像测量（匹兹堡化合物 B 的β-淀粉样蛋白和 tau（Flortaucipir））之间的横断面关联，协变量包括年龄、性别、教育程度以及 PET 扫描-冷漠评估之间的时间。
AES-I 与β-淀粉样蛋白和颞叶 tau 显著相关，并且在进一步调整抑郁症状后，这些关联仍然存在。AES-S 与 AD 生物标志物之间的关联不显著。在认知无障碍且 Aβ升高的个体的探索性亚组分析中，我们观察到 AES-I 与下颞叶 tau 之间存在关联。
老年人大脑冷漠的研究伙伴报告，而不是自我报告，与 AD 病理学有关，我们从临床前阶段就观察到了这种关系。我们的发现强调了在捕捉 AD 相关冷漠时使用旁证信息的重要性。
