Association of anxiety with subcortical amyloidosis in cognitively normal older adults

Mol Psychiatry. 2020 Oct;25(10):2599-2607. doi: 10.1038/s41380-018-0214-2. Epub 2018 Aug 16.

Abstract

Late-life anxiety has been associated with increased progression from normal cognition to amnestic MCI, suggesting that anxiety may be a neuropsychiatric symptom of Alzheimer's disease (AD) pathological changes and a possible marker of anatomical progression in preclinical AD. This study examined whether cortical or subcortical amyloidosis, indicating earlier or later stages of preclinical AD, was associated with greater self-reported anxiety among 118 cognitively normal volunteers, aged 65-90 years, and whether this association was stronger in APOEε4 carriers. Participants underwent Pittsburgh Compound B Positron Emission Tomography (PiB-PET) to assess fibrillar amyloid-β burden in cortical and subcortical regions, and measurement of anxiety using the Hospital Anxiety and Depression Scale-anxiety subscale. Higher PiB-PET measures in the subcortex (striatum, amygdala, and thalamus), but not in the cortex, were associated with greater anxiety, adjusting for demographics, cognition, and depression. Findings were similar using a cortico-striatal staging system and continuous PET measurements. Anxiety was highest in APOEε4 carriers with subcortical amyloidosis. This work supports in vivo staging of amyloid-β deposition in both cortical and subcortical regions as a promising approach to the study of neuropsychiatric symptoms such as anxiety in cognitively normal older individuals. Elevated anxiety symptoms in combination with high-risk biological factors such as APOEε4 and subcortical amyloid-β may identify participants closest to MCI for secondary prevention trials.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / prevention & control
  • Alzheimer Disease / psychology
  • Amyloid beta-Peptides / metabolism
  • Amyloidosis / complications*
  • Amyloidosis / diagnostic imaging
  • Amyloidosis / metabolism
  • Amyloidosis / psychology
  • Anxiety / complications*
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Female
  • Health*
  • Humans
  • Male
  • Positron-Emission Tomography

Substances

  • Amyloid beta-Peptides