Affective symptoms as predictors of Alzheimer's disease in subjects with mild cognitive impairment: a 10-year follow-up study

Abstract

Background. Affective symptoms are common in subjects with mild cognitive impairment (MCI), but there is disagreement whether these symptoms are predictive for Alzheimer's disease (AD). We investigated the predictive accuracy of affective symptoms for AD during a follow-up study in subjects with MCI, and whether the predictive accuracy was modified by age, the presence of amnestic MCI or the length of follow-up.Method. Newly referred subjects (n=263) with MCI older than 55 years were selected from a memory clinic and followed up after 2, 5 and 10 years. Predictors investigated were : symptoms of depression, anxiety, apathy and sleeping problems.Results. Affective symptoms were present in 50-70 % of the subjects. The average follow-up period was 5.4 years and 79 subjects (29 %) developed AD. Sleeping problems were associated with a decreased risk for AD [odds ratio (OR) 0.35, p<0.001]. Symptoms of depression (OR 0.61, p=0.059) and anxiety (OR 0.58, p=0.051) showed a trend in the same direction. The OR of apathy for AD was 0.67 (p=0.14). Depression was associated with a decreased risk for AD only in subjects without amnestic MCI, but not in subjects with amnestic MCI. Moreover, anxiety was related to the risk for AD differently between subjects diagnosed with AD at the 5-year follow-up (OR 0.23) and subjects diagnosed with AD at the 10-year follow-up (OR 1.7).Conclusions. Affective symptoms are associated with a decreased risk for AD. The risk may be dependent on MCI subtype or length of follow-up, but it does not depend on age.

Depression in Mild Cognitive Impairment is associated with Progression to Alzheimer's Disease: A Longitudinal Study

“…Our findings are in line with previous research, acknowledging that depression or depressive symptoms are of prognostic value for progression from MCI to AD [38][39][40][41][42][43], although this could not be demonstrated in some other studies [44][45][46][47][48][49][50]. One study even found a negative correlation between progression and the presence of affective symptoms [51]. Nevertheless, this conflicting evidence might be due to differences in study methodology, such as MCI definition, assessment instruments, sample size, statistics, follow-up term, research setting, etc.…”

Depression in Mild Cognitive Impairment is associated with Progression to Alzheimer's Disease: A Longitudinal Study

“…Our findings are in line with previous research, acknowledging that depression or depressive symptoms are of prognostic value for progression from MCI to AD [38][39][40][41][42][43], although this could not be demonstrated in some other studies [44][45][46][47][48][49][50]. One study even found a negative correlation between progression and the presence of affective symptoms [51]. Nevertheless, this conflicting evidence might be due to differences in study methodology, such as MCI definition, assessment instruments, sample size, statistics, follow-up term, research setting, etc.…”

The symptom of low mood in the prodromal stage of mild cognitive impairment and dementia: a cohort study of a community dwelling elderly population

“…This finding is in line with some progression studies of MCI4 12–14 16 and is at odds with others 8–11 15. Indeed, most of the studies that found no association or an inverse association focused on depressive symptoms measured at the same time of MCI detection 8 9 11 15. We showed that only low mood measured at baseline, 3 years before the detection of MCI, predicted subsequent progression of MCI to dementia.…”

Neuropsychiatric Symptoms in Amnestic Mild Cognitive Impairment: Increased Risk and Faster Progression to Dementia

“…Thus these three are the items with the most significant impact on the risk of progression form a-MCI to any type of dementia. Our study has simultaneously analysed a wide range of neuropsychiatric symptoms, and the results are in line with what found in several studies analysing apathy [24][25][26][27][28] and anxiety [29,30] separately using specific scales for the diagnosis of either.…”

Depression in Mild Cognitive Impairment is associated with Progression to Alzheimer's Disease: A Longitudinal Study

“…Our findings are in line with previous research, acknowledging that depression or depressive symptoms are of prognostic value for progression from MCI to AD [38][39][40][41][42][43], although this could not be demonstrated in some other studies [44][45][46][47][48][49][50]. One study even found a negative correlation between progression and the presence of affective symptoms [51]. Nevertheless, this conflicting evidence might be due to differences in study methodology, such as MCI definition, assessment instruments, sample size, statistics, follow-up term, research setting, etc.…”

The symptom of low mood in the prodromal stage of mild cognitive impairment and dementia: a cohort study of a community dwelling elderly population

“…This finding is in line with some progression studies of MCI4 12–14 16 and is at odds with others 8–11 15. Indeed, most of the studies that found no association or an inverse association focused on depressive symptoms measured at the same time of MCI detection 8 9 11 15. We showed that only low mood measured at baseline, 3 years before the detection of MCI, predicted subsequent progression of MCI to dementia.…”

Neuropsychiatric Symptoms in Amnestic Mild Cognitive Impairment: Increased Risk and Faster Progression to Dementia

“…Thus these three are the items with the most significant impact on the risk of progression form a-MCI to any type of dementia. Our study has simultaneously analysed a wide range of neuropsychiatric symptoms, and the results are in line with what found in several studies analysing apathy [24][25][26][27][28] and anxiety [29,30] separately using specific scales for the diagnosis of either.…”

Depression in Mild Cognitive Impairment is associated with Progression to Alzheimer's Disease: A Longitudinal Study

“…Our findings are in line with previous research, acknowledging that depression or depressive symptoms are of prognostic value for progression from MCI to AD [38][39][40][41][42][43], although this could not be demonstrated in some other studies [44][45][46][47][48][49][50]. One study even found a negative correlation between progression and the presence of affective symptoms [51]. Nevertheless, this conflicting evidence might be due to differences in study methodology, such as MCI definition, assessment instruments, sample size, statistics, follow-up term, research setting, etc.…”

The symptom of low mood in the prodromal stage of mild cognitive impairment and dementia: a cohort study of a community dwelling elderly population

“…This finding is in line with some progression studies of MCI4 12–14 16 and is at odds with others 8–11 15. Indeed, most of the studies that found no association or an inverse association focused on depressive symptoms measured at the same time of MCI detection 8 9 11 15. We showed that only low mood measured at baseline, 3 years before the detection of MCI, predicted subsequent progression of MCI to dementia.…”

Neuropsychiatric Symptoms in Amnestic Mild Cognitive Impairment: Increased Risk and Faster Progression to Dementia

“…Thus these three are the items with the most significant impact on the risk of progression form a-MCI to any type of dementia. Our study has simultaneously analysed a wide range of neuropsychiatric symptoms, and the results are in line with what found in several studies analysing apathy [24][25][26][27][28] and anxiety [29,30] separately using specific scales for the diagnosis of either.…”