Psychiatric symptoms in Alzheimer's disease
Date:
April 19, 2022
Source:
Lund University
Summary:
In addition to memory problems and other cognitive symptoms, most
people with Alzheimer's disease also suffer from mental health
issues. It has long been unclear whether these occur because of
tissue changes in the brain, or whether they represent psychological
reactions to cognitive symptoms.
FULL STORY ==========================================================================
In addition to memory problems and other cognitive symptoms, most people
with Alzheimer's disease also suffer from mental health issues. It has
long been unclear whether these occur because of tissue changes in the
brain, or whether they represent psychological reactions to cognitive
symptoms. A study from Lund University in Sweden has provided new insight,
and is published in Biological Psychiatry.
========================================================================== Cognitive symptoms combined with elevated levels of certain proteins
form the basis for diagnosis of Alzheimer's disease. At the same time, researchers and physician alike have, over the past decade, recognised
that changes in mood and behaviour are often very early signs of the
disease. Yet, these symptoms have not received as much scientific
attention as cognitive ones.
Now, researchers from Lund University have investigated the complex relationships between psychological symptoms, Alzheimer's proteins
and cognitive symptoms. This was done within the framework of the internationally renowned BioFINDER study, led by Professor Oskar Hansson.
The study examined 356 people over the age of 65 with no cognitive
symptoms at the start of the research. In addition to analysing the levels
of the Alzheimer's proteins amyloid beta and phosphorylated tau in their cerebrospinal fluid, participants' levels of anxiety, apathy and overall cognitive function were also assessed on a biannual basis. Participants
were followed for a total of eight years.
When data was analyzed, the researchers found a clear link between
elevated levels of amyloid beta at the start of the study and future development of anxiety and apathy.
Maurits Johansson, physician and lead author of the study, explains: "Alzheimer's disease affects large parts of the brain, including
the regions that control our emotional life. Our study shows that
psychiatric symptoms, just like cognitive symptoms, occur mainly as
a direct consequence of the underlying changes to the brain, due to
increased levels of amyloid beta." The researchers further demonstrated
that amyloid beta drives the development of apathy predominately through
direct effects, and that apathy only to a limited extent evolves secondary
to cognitive decline. Anxiety was not linked to cognitive change.
"The findings thus argue against the idea that these early changes in
emotion and motivation in Alzheimer's disease are primarily psychological reactions to cognitive decline. Instead, the results suggest that
for apathy and anxiety at least, these occur due to the pathological accumulation of amyloid beta," clarifies Professor Oskar Hansson.
"Our findings imply that psychiatric symptoms in Alzheimer's disease could
be used as alternative outcome measures in treatment trials. Ultimately,
this could lead to more effective study design," he continues.
"A previous BioFINDER study suggested that the presence of anxiety or
apathy among elderly people who continued to show no signs of dementia
may point to an increased risk of future cognitive impairment. As a next
step, studies are needed to clarify how these symptoms may contribute
to the established clinical diagnosis in the early stages of disease,
possibly even before cognition has been affected," they conclude.
========================================================================== Story Source: Materials provided by Lund_University. Note: Content may
be edited for style and length.
========================================================================== Journal Reference:
1. Maurits Johansson, Erik Stomrud, Per Maarten Johansson, Anna
Svenningsson, Sebastian Palmqvist, Shorena Janelidze, Danielle
van Westen, Niklas Mattsson-Carlgren, Oskar Hansson. Development
of Apathy, Anxiety, and Depression in Cognitively Unimpaired
Older Adults: Effects of Alzheimer's Disease Pathology
and Cognitive Decline. Biological Psychiatry, 2022; DOI:
10.1016/j.biopsych.2022.01.012 ==========================================================================
Link to news story:
https://www.sciencedaily.com/releases/2022/04/220419103206.htm
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