Conversion to Mild Cognitive Impairment and Alzheimer's Disease Dementia Related to Apathy, APOE Genotype and Antidepressant Use.

IF 2.9 4区 医学 Q2 CLINICAL NEUROLOGY
Rubina Malik, Miguel Restrepo Martinez, Isis So, Elizabeth Finger
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引用次数: 0

Abstract

ObjectiveApathy and APOE ε4 genotype are risk factors for developing Alzheimer's disease dementia (ADD). Antidepressant use is known to induce apathy. This study aimed to examine associations between APOE ε4, apathy, and antidepressant use with progression from cognitively normal (CN) to mild cognitive impairments (MCI), and MCI to ADD.MethodsParticipants aged 55-90 were recruited from the Alzheimer's Disease Neuroimaging Initiative. Participants were CN or had MCI at baseline and had completed at least 3 consecutive study visits. The NPI and NPI-Q apathy subscales were used to index the presence of apathy. Antidepressants used by participants included SSRIs, SNRIs, and AYTADs. Cox proportional hazards analyses examined the combined effects of apathy, APOE ε4 genotype, and antidepressant use on conversion from CN to MCI and from MCI to ADD.ResultsApathy and APOE ε4 were associated with increased risk of conversion along the CN-MCI-ADD continuum. Antidepressant use was associated with progression from MCI to ADD, and progression from CN to MCI in non-apathetic APOE ε4 carriers.ConclusionOur findings support apathy and APOE ε4 as robust predictors of conversion to MCI and ADD, and demonstrate novel associations between antidepressant use and conversion. Future research should explore whether antidepressant use in MCI and ADD causes apathetic symptoms or serves to index apathy/depression severity.

转化为轻度认知障碍和阿尔茨海默病痴呆相关的冷漠,APOE基因型和抗抑郁药的使用。
目的冷漠和APOE ε4基因型是阿尔茨海默病痴呆(ADD)发生的危险因素。抗抑郁药的使用会引起冷漠。本研究旨在研究APOE ε4、冷漠和抗抑郁药使用与认知正常(CN)到轻度认知障碍(MCI)以及MCI到add进展之间的关系。方法从阿尔茨海默病神经影像学计划招募年龄在55-90岁之间的参与者。参与者为CN或基线时患有MCI,并且完成了至少3次连续的研究访问。NPI和NPI- q冷漠分量表被用来衡量冷漠的存在。参与者使用的抗抑郁药包括SSRIs、SNRIs和AYTADs。Cox比例风险分析考察了冷漠、APOE ε4基因型和抗抑郁药使用对从CN到MCI和从MCI到add的转化的综合影响。结果冷漠和APOE ε4与CN-MCI- add连续体转化的风险增加相关。在非冷漠APOE ε4携带者中,抗抑郁药物的使用与从MCI到ADD的进展以及从CN到MCI的进展相关。结论我们的研究结果支持冷漠和APOE ε4是MCI和ADD转化的可靠预测因子,并证明了抗抑郁药物使用与转化之间的新关联。未来的研究应探讨在轻度认知障碍和注意力缺陷多动症患者中使用抗抑郁药是否会导致冷漠症状,或是否可作为冷漠/抑郁严重程度的指标。
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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
40
审稿时长
>12 weeks
期刊介绍: Journal of Geriatric Psychiatry and Neurology (JGP) brings together original research, clinical reviews, and timely case reports on neuropsychiatric care of aging patients, including age-related biologic, neurologic, and psychiatric illnesses; psychosocial problems; forensic issues; and family care. The journal offers the latest peer-reviewed information on cognitive, mood, anxiety, addictive, and sleep disorders in older patients, as well as tested diagnostic tools and therapies.
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