Cerebrospinal fluid amyloid status and affective symptoms in mild cognitive impairment

Abstract

AbstractBackgroundAffective and cognitive symptoms are common in old age, and frequently overlap in clinical practice. Mild cognitive impairment (MCI), for example, is a risk state for later dementia where neuropsychiatric symptoms such as depression and anxiety are common. The exact nature of this overlap remains unclear ‐ affective symptoms may be both causative of cognitive issues, they may be related to an underlying neurodegenerative disease, or may stem from common risk factors. Biomarkers of brain diseases such as Alzheimer’s can help determine the etiology of MCI and aid in predicting the risk of progression to dementia.AimsTo determine whether CSF‐based amyloid positive and amyloid negative individuals with MCI differ in the nature and prevalence of affective symptoms.MethodAn existing database of 476 individuals with MCI will be used. All subjects underwent extensive cognitive and behavioural assessment at baseline and follow‐up (up to 7 years). Behaviour was assessed covering a period of 2 weeks prior to inclusion and at each follow‐up visit using a battery of behavioural assessment scales: Middelheim Frontality Score (MFS), Behave‐AD, Cohen‐Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia and Geriatric Depression Scale (30 items). In a significant subgroup of these patients, the standard AD CSF biomarkers (Aβ, T‐tau, P‐tau181) have been analysed. We will evaluate whether subgroups with differing amyloid status (i.e. normal vs. abnormal CSF biomarkers) are significantly different in the nature and prevalence of affective symptoms as determined by several scales (Behave‐AD, Geriatric Depression Scale, Cornell Scale for Depression in Dementia).ResultsWe will compare prevalence, nature and severity of affective symptoms between subgroups of MCI patients (amyloid positive versus amyloid negative; AD CSF biomarker profile suggestive for AD versus not suggestive for AD). Presence and severity of affective symptoms will be related to (rate of) cognitive decline using neuropsychological data (e.g. yearly decline of total MMSE score).ConclusionWe expect to find more (severe) affective symptoms in MCI due to AD (as compared to MCI not due to AD) and to find an association between these symptoms and rate of cognitive decline. The results will be presented at AAIC 2020 in Amsterdam.