The association between AD biomarkers and neuropsychiatric symptoms in subjective cognitive decline; the SCIENCe project

Abstract

AbstractBackgroundNeuropsychiatric symptoms (NPS) are increasingly recognized as non‐cognitive manifestation of Alzheimer’s disease (AD). However, the relationship between AD‐related pathology and NPS remains unclear. We aimed to investigate the cross‐sectional association between Alzheimer biomarkers and neuropsychiatric symptoms (NPS) in individuals with subjective cognitive decline (SCD) presenting at a memory clinic. In addition, we evaluated personality traits and education as potentially modifying factors of this association.MethodWe included 346 individuals with SCD (age: 62.9±7.8) from the SCIENCe cohort, including 92 amyloid positive participants (age: 66.4±7.0, Female: 44.6%, MMSE: 28.5±1.3) and 254 amyloid negative participants (age: 61.6±7.7, Female: 40.6%, MMSE: 28.6±1.3). Amyloid status was determined by amyloid PET or CSF biomarkers according to visual read or established cut points. Neuropsychiatric symptoms were assessed using the Geriatric Depression Scale (GDS; n = 282), the Center for Epidemiological Studies‐Depression (CES‐D; n = 225), the Hospital Anxiety and Depression Scale – anxiety subscale (HADS‐A; n = 225) and the Neuropsychiatric Inventory Questionnaire (NPI‐Q; n = 198). We used linear regression analyses, adjusted for age and sex, to assess the association between amyloid status and NPS. In secondary analyses, we tested for interactions between amyloid status and (1) neuroticism (Dutch Personality Questionnaire), (2) somatization, (Four‐Dimensional Symptom Questionnaire), and (3) educational level (Dutch Verhage scale).ResultAmyloid status was not associated with GDS, CES‐D, HADS‐A and NPI‐Q scores in univariable analyses. When we evaluated effect modification, we found an interaction between amyloid status and neuroticism in the association with NPI‐Q (p<0.05), indicating a positive association between amyloid status and NPS in participants with a low level of neuroticism (β: 2.56±2.24), and a negative association in participants with a high level of neuroticism (β: ‐4.09±3.23).ConclusionIn this cross‐sectional analysis in individuals with SCD, amyloid status was hardly associated with neuropsychiatric symptoms. In future studies, we focus on amyloid status as determinant of change in NPS over time.