Association of brain amyloidosis with the incidence and frequency of neuropsychiatric symptoms in ADNI: a multisite observational cohort study
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Objective: To investigate the relationship between amyloid burden and frequency of existing and incidence of new neuropsychiatric symptoms (NPS) in elderly with and without cognitive decline. Methods: 275 cognitively normal controls (NC), 100 subjective memory complaint (SMC), 559 mild cognitive impairment (MCI) and 143 Alzheimer’s disease dementia subjects from the Alzheimer’s Disease Neuroimaging Initiative received ( 18 F)-florbetapir positron emission tomography (PET) scans. Yearly neuropsychiatric inventory (Neuropsychiatric Inventory (NPI)/NPI-Questionnaire) data were collected from the study partners at each visit. Mean standard uptake volume ratios (SUVR) normalised to whole cerebellum were obtained. Positive amyloid PET scan was defined as mean SUVR ≥1.17. Fisher’s exact test was used to compare frequency and incidence between amyloid positive and amyloid negative subjects. Survival analyses were used to estimate of neuropsychiatric symptoms (NPS) between amyloid positive and amyloid negative subjects. Survival analyses were used to estimate hazard ratios for developing the most common NPS by amyloid status. Results: No differences in NPS frequency were seen between amyloid positive and amyloid negative NC, SMC, MCI or dementia groups. MCI subjects with amyloid pathology however tended to have greater frequency x severity (FxS) of anxiety, hallucinations, delusions, apathy, disinhibition, irritability, aberrant motor behavior, and appetite, but not agitation, depression, night-time disturbances, or elation. MCI subjects with amyloid pathology were at greater risk for developing apathy, anxiety and agitation over time. Baseline presence of agitation and apathy and new onset agitation, irritability and apathy predicted faster conversion to dementia among MCI subjects. Conclusions: Amyloid pathology is associated with greater rate of development of new NPS in MCI. Anxiety and delusions are significant predictors of amyloid pathology. Agitation, irritability and apathy are significant predictors for conversion from MCI to dementia.
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Lifestyle interventions such as exercise and eating a healthy diet have been shown to be effective in reducing SNS activation, which in part may be mediated by improving cardiometabolic risk factors.
“Furthermore, lifestyle interventions such as exercise and eating a healthy diet have been shown to be effective in reducing SNS activation, which in part may be mediated by improving these cardiometabolic risk factors92,94.”
From Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health (2021) · cites this paper as [94]
The Methods and Results examine brain amyloidosis, neuropsychiatric symptoms, and conversion from mild cognitive impairment to dementia. Searches for SNS activation, exercise, diet, and cardiometabolic risk factors found no passage addressing whether lifestyle interventions reduce SNS activation or how such an effect might be mediated. (LLM, conf=0.77)
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Pathological Correlations of Neuropsychiatric Symptoms in Institutionalized People with Dementia
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Neuropsychiatric symptoms and white matter hyperintensities in older adults without dementia
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Behavioral and Psychological Symptoms (BPSD) in Alzheimer’s Disease (AD): Development and Treatment
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Prodromal Dementia With Lewy Bodies and Recurrent Panic Attacks as the First Symptom: A Case Report
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Neuropsychiatric Symptoms Associated With Frontotemporal Atrophy in Older Adults Without Dementia
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Neuropsychiatric Manifestations in Alzheimer’s Disease Patients: Genetics and Treatment Options
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- Authors
- Goukasian, N., Hwang, K. S., Romero, T., Grotts, J., Do, T. M., Groh, J. R., Bateman, D. R., & Apostolova, L. G.
- Affiliations
- University of Vermont (US)
- Emory University (US)
- University of California, Los Angeles (US)
- Tulane University (US)
- Indiana University School of Medicine (US)
- Corresponding author
- Apostolova, Liana G.
- ORCID
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2019-12
- Volume
- 9
- Issue
- 12
- Pages
- e031947
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC6937083
- OpenAlex
- W2995244706
- Cited by
- 64
- References
- 52
- Citations by year
- 2026: 9 · 2025: 7 · 2024: 16 · 2023: 8 · 2022: 8 · 2021: 9 · 2020: 6 · 2019: 1
- FWCI
- 4.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- IUScholarWorks (Indiana University) (submittedVersion, cc-by-nc)
- Purdue University Indianapolis (Indiana University) (submittedVersion, cc-by-nc)
- Funders
- National Institutes of Health (5u01ag024904-10)
- University of California, Los Angeles
- National Institute on Aging (U01-AG-024904, P30AG010133, K02AG048240, P50AG016570, R01AG040770)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- cerebral amyloidosis, neuropsychiatric symptoms, Alzheimer's disease, mild cognitive impairment, conversion to dementia, amyloid PET, florbetapir, apathy, agitation, anxiety, delusions, irritability
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Amyloidosis, Behavioral Symptoms, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Surveys and Questionnaires, Risk Factors, Case-Control Studies, Disease Progression, Positron-Emission Tomography, Cognitive Dysfunction
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