The Synergic Effect of AT(N) Profiles and Depression on the Risk of Conversion to Dementia in Patients with Mild Cognitive Impairment.
Marta MarquiéFernando García-GutiérrezAdelina OrellanaLaura MontrrealItziar De RojasPablo García-GonzálezRaquel PuertaClàudia OlivéAmanda CanoIsabel HernándezMaitée Rosende-RocaLiliana VargasJuan Pablo TartariEster Esteban-De AntonioUrszula BojarynMario RicciardiDiana M AritonVanesa PytelMontserrat AlegretGemma OrtegaAna EspinosaAlba Pérez-CordónÁngela SanabriaNathalia MuñozNúria LleonartNúria AguileraAinhoa García-SánchezEmilio Alarcón-MartínLluís TárragaAgustin RuizMercè BoadaSergi ValeroPublished in: International journal of molecular sciences (2023)
Few studies have addressed the impact of the association between Alzheimer's disease (AD) biomarkers and NPSs in the conversion to dementia in patients with mild cognitive impairment (MCI), and no studies have been conducted on the interaction effect of these two risk factors. AT(N) profiles were created using AD-core biomarkers quantified in cerebrospinal fluid (CSF) (normal, brain amyloidosis, suspected non-Alzheimer pathology (SNAP) and prodromal AD). NPSs were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). A total of 500 individuals with MCI were followed-up yearly in a memory unit. Cox regression analysis was used to determine risk of conversion, considering additive and multiplicative interactions between AT(N) profile and NPSs on the conversion to dementia. A total of 224 participants (44.8%) converted to dementia during the 2-year follow-up study. Pathologic AT(N) groups (brain amyloidosis, prodromal AD and SNAP) and the presence of depression and apathy were associated with a higher risk of conversion to dementia. The additive combination of the AT(N) profile with depression exacerbates the risk of conversion to dementia. A synergic effect of prodromal AD profile with depressive symptoms is evidenced, identifying the most exposed individuals to conversion among MCI patients.
Keyphrases
- mild cognitive impairment
- cognitive decline
- depressive symptoms
- risk factors
- cerebrospinal fluid
- parkinson disease
- sleep quality
- end stage renal disease
- prognostic factors
- social support
- resting state
- ejection fraction
- newly diagnosed
- pulmonary embolism
- chronic kidney disease
- cross sectional
- multiple myeloma
- white matter
- squamous cell carcinoma
- working memory
- multiple sclerosis
- neoadjuvant chemotherapy
- radiation therapy
- functional connectivity
- blood brain barrier
- physical activity
- peritoneal dialysis
- deep brain stimulation