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Chronic Depressive Symptomatology in Mild Cognitive Impairment Is Associated with Frontal Atrophy Rate which Hastens Conversion to Alzheimer Dementia

Sacuiu, Simona; Insel, Philip S LU ; Mueller, Susanne; Tosun, Duygu; Mattsson, Niklas LU ; Jack, Clifford R; DeCarli, Charles; Petersen, Ronald C; Aisen, Paul S. and Weiner, Michael W, et al. (2016) In American Journal of Geriatric Psychiatry 24(2). p.35-126
Abstract

OBJECTIVE: Investigate the association of chronic depressive symptomatology (chrDS) with cortical atrophy rates and conversion to Alzheimer dementia (AD) over 3 years in mild cognitive impairment (MCI).

METHODS: In a multicenter, clinic-based study, MCI elderly participants were selected from the Alzheimer's Disease Neuroimaging Initiative repository, based on availability of both serial structural magnetic resonance imaging and chrDS endorsed on three depression-related items from the Neuropsychiatric Inventory Questionnaire (chrDS N = 32 or no depressive symptoms N = 62) throughout follow-up. Clinical and laboratory investigations were performed every 6 months during the first 2 years and yearly thereafter (median follow-up: 3... (More)

OBJECTIVE: Investigate the association of chronic depressive symptomatology (chrDS) with cortical atrophy rates and conversion to Alzheimer dementia (AD) over 3 years in mild cognitive impairment (MCI).

METHODS: In a multicenter, clinic-based study, MCI elderly participants were selected from the Alzheimer's Disease Neuroimaging Initiative repository, based on availability of both serial structural magnetic resonance imaging and chrDS endorsed on three depression-related items from the Neuropsychiatric Inventory Questionnaire (chrDS N = 32 or no depressive symptoms N = 62) throughout follow-up. Clinical and laboratory investigations were performed every 6 months during the first 2 years and yearly thereafter (median follow-up: 3 years; interquartile range: 1.5-4.0 years). Cortical atrophy rates in 16 predefined frontotemporoparietal regions affected in major depression and AD and the rate of incident AD at follow-up.

RESULTS: ChrDS in a single domain amnestic MCI sample were associated with accelerated cortical atrophy in the frontal lobe and anterior cingulate but not with atrophy rates in temporomedial or other AD-affected regions. During follow-up, 38 participants (42.7%) developed AD. Participants with chrDS had 60% shorter conversion time to AD than those without depressive symptoms. This association remained significant in survival models adjusted for temporomedial atrophy rates and showed the same trend in models adjusted for frontal cortical atrophy rate, which all increased the risk of AD.

CONCLUSION: Our results suggest that chrDS associated with progressive atrophy of frontal regions may represent an additional risk factor for conversion to dementia in MCI as opposite to representing typical prodromal AD symptomatology.

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keywords
Aged, Aged, 80 and over, Alzheimer Disease, Atrophy, Cerebral Cortex, Cognitive Dysfunction, Depression, Depressive Disorder, Major, Disease Progression, Female, Humans, Magnetic Resonance Imaging, Male, Neuroimaging, Neuropsychological Tests, Psychiatric Status Rating Scales, Journal Article, Multicenter Study, Observational Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
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American Journal of Geriatric Psychiatry
volume
24
issue
2
pages
10 pages
publisher
Elsevier
external identifiers
  • scopus:84962574847
ISSN
1545-7214
DOI
10.1016/j.jagp.2015.03.006
language
English
LU publication?
no
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46e8070f-c279-4094-b28b-0af708b6d3c2
date added to LUP
2017-02-02 09:11:53
date last changed
2017-11-12 04:28:35
@article{46e8070f-c279-4094-b28b-0af708b6d3c2,
  abstract     = {<p>OBJECTIVE: Investigate the association of chronic depressive symptomatology (chrDS) with cortical atrophy rates and conversion to Alzheimer dementia (AD) over 3 years in mild cognitive impairment (MCI).</p><p>METHODS: In a multicenter, clinic-based study, MCI elderly participants were selected from the Alzheimer's Disease Neuroimaging Initiative repository, based on availability of both serial structural magnetic resonance imaging and chrDS endorsed on three depression-related items from the Neuropsychiatric Inventory Questionnaire (chrDS N = 32 or no depressive symptoms N = 62) throughout follow-up. Clinical and laboratory investigations were performed every 6 months during the first 2 years and yearly thereafter (median follow-up: 3 years; interquartile range: 1.5-4.0 years). Cortical atrophy rates in 16 predefined frontotemporoparietal regions affected in major depression and AD and the rate of incident AD at follow-up.</p><p>RESULTS: ChrDS in a single domain amnestic MCI sample were associated with accelerated cortical atrophy in the frontal lobe and anterior cingulate but not with atrophy rates in temporomedial or other AD-affected regions. During follow-up, 38 participants (42.7%) developed AD. Participants with chrDS had 60% shorter conversion time to AD than those without depressive symptoms. This association remained significant in survival models adjusted for temporomedial atrophy rates and showed the same trend in models adjusted for frontal cortical atrophy rate, which all increased the risk of AD.</p><p>CONCLUSION: Our results suggest that chrDS associated with progressive atrophy of frontal regions may represent an additional risk factor for conversion to dementia in MCI as opposite to representing typical prodromal AD symptomatology.</p>},
  author       = {Sacuiu, Simona and Insel, Philip S and Mueller, Susanne and Tosun, Duygu and Mattsson, Niklas and Jack, Clifford R and DeCarli, Charles and Petersen, Ronald C and Aisen, Paul S. and Weiner, Michael W and Mackin, R Scott and , },
  issn         = {1545-7214},
  keyword      = {Aged,Aged, 80 and over,Alzheimer Disease,Atrophy,Cerebral Cortex,Cognitive Dysfunction,Depression,Depressive Disorder, Major,Disease Progression,Female,Humans,Magnetic Resonance Imaging,Male,Neuroimaging,Neuropsychological Tests,Psychiatric Status Rating Scales,Journal Article,Multicenter Study,Observational Study,Research Support, N.I.H., Extramural,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {2},
  pages        = {35--126},
  publisher    = {Elsevier},
  series       = {American Journal of Geriatric Psychiatry},
  title        = {Chronic Depressive Symptomatology in Mild Cognitive Impairment Is Associated with Frontal Atrophy Rate which Hastens Conversion to Alzheimer Dementia},
  url          = {http://dx.doi.org/10.1016/j.jagp.2015.03.006},
  volume       = {24},
  year         = {2016},
}