Bacci Julia R, Rudolph Marc D, Craft Suzanne, Bateman James R, Lockhart Samuel N, Mielke Michelle M
Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Department of Internal Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
Int J Geriatr Psychiatry. 2025 Aug;40(8):e70140. doi: 10.1002/gps.70140.
In a sample of community-dwelling older adults, we examined the association of Alzheimer's Disease and Related Dementias (AD/ADRD) blood-based biomarkers (BBMs) and neuropsychiatric symptoms (NPS) and whether informant type (i.e., spouse vs. child vs. other) modified that association.
This study included 430 participants with a cognitively unimpaired or mild cognitive impairment consensus diagnosis from the Wake Forest Alzheimer's Disease Research Center Clinical Core cohort. Informants reported NPS using the Neuropsychiatric Inventory Questionnaire. AD/ADRD BBMs included the Aβ42/40 ratio, p-tau181, p-tau217, NfL, and GFAP. Generalized linear models were used to examine the associations between AD/ADRD BBMs and NPS. Secondary models adjusted for age, sex, education, race, and cognitive status. Tertiary models adjusted for covariates in secondary models, as well as informant type. Interactions between informant type and AD/ADRD BBMs were examined.
Higher p-tau217 was associated with higher NPS in both unadjusted models and models adjusted for demographics and cognitive status. This association was attenuated and no longer statistically significant after additionally adjusting for informant type. Significant interactions of informant type and p-tau181 or p-tau217 on NPS were demonstrated, where p-tau181 or p-tau217 were more strongly associated with NPS reported by children compared to spouses.
Informant type modified the association between AD/ADRD BBMs and NPS, with stronger associations observed when symptoms were reported by child informants compared to spouse informants. These findings have important implications for earlier detection of individuals with AD/ADRD pathologies.
在一组社区居住的老年人样本中，我们研究了阿尔茨海默病及相关痴呆症（AD/ADRD）的血液生物标志物（BBM）与神经精神症状（NPS）之间的关联，以及信息提供者类型（即配偶、子女或其他）是否会改变这种关联。
本研究纳入了430名来自维克森林大学阿尔茨海默病研究中心临床核心队列的参与者，他们经共识诊断为认知未受损或轻度认知障碍。信息提供者使用神经精神症状问卷报告NPS。AD/ADRD的BBM包括Aβ42/40比值、p-tau181、p-tau217、神经丝轻链（NfL）和胶质纤维酸性蛋白（GFAP）。使用广义线性模型研究AD/ADRD的BBM与NPS之间的关联。二级模型对年龄、性别、教育程度、种族和认知状态进行了调整。三级模型在二级模型的协变量基础上，还对信息提供者类型进行了调整。研究了信息提供者类型与AD/ADRD的BBM之间的相互作用。
在未调整模型以及调整了人口统计学和认知状态的模型中，较高的p-tau217与较高的NPS相关。在进一步调整信息提供者类型后，这种关联减弱且不再具有统计学意义。信息提供者类型与p-tau181或p-tau217对NPS存在显著的相互作用，与配偶报告的相比，p-tau181或p-tau217与子女报告的NPS关联更强。
信息提供者类型改变了AD/ADRD的BBM与NPS之间的关联，与配偶信息提供者相比，当症状由子女信息提供者报告时，关联更强。这些发现对早期发现患有AD/ADRD病理的个体具有重要意义。
