title: Anxiety is related to Alzheimer cerebrospinal fluid markers in subjects with mild cognitive impairment.
abstract: BACKGROUND
  Anxiety, apathy and depression are common in subjects with mild cognitive impairment (MCI) and may herald Alzheimer's disease (AD). We investigated whether these symptoms correlated with cerebrospinal fluid (CSF) markers for AD in subjects with MCI. Method Subjects with MCI (n=268) were selected from the 'Development of screening guidelines and criteria for pre-dementia Alzheimer's disease' (DESCRIPA) and Alzheimer's Disease Neuroimaging Initiative (ADNI) studies. We measured amyloid β(1-42) protein (Aβ42) and total tau (t-tau) in CSF. Neuropsychiatric symptoms were measured with the Neuropsychiatric Inventory.
  
  
  RESULTS
  Depressive symptoms were reported by 55 subjects (21%), anxiety by 35 subjects (13%) and apathy by 49 subjects (18%). The presence of anxiety was associated with abnormal CSF Aβ42 [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.6-3.3] and t-tau (OR 2.6, 95% CI 1.9-3.6) concentrations and with the combination of abnormal concentrations of both Aβ42 and t-tau (OR 3.1, 95% CI 2.0-4.7). The presence of agitation and irritability was associated with abnormal concentrations of Aβ42 (agitation: OR 1.6, 95% CI 1.1-2.3; irritability: OR 2.2, 95% CI 1.5-3.3). Symptoms of depression and apathy were not related to any of the CSF markers.
  
  
  CONCLUSIONS
  In subjects with MCI, symptoms of anxiety, agitation and irritability may reflect underlying AD pathology, whereas symptoms of depression and apathy do not.
authors.affiliation: Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, The Netherlands. i.ramakers@maastrichtuniversity.nl
authors.forename: I H G B
authors.initials: IH
authors.lastname: Ramakers
authors.forename: F R J
authors.initials: FR
authors.lastname: Verhey
authors.forename: P
authors.initials: P
authors.lastname: Scheltens
authors.forename: H
authors.initials: H
authors.lastname: Hampel
authors.forename: H
authors.initials: H
authors.lastname: Soininen
authors.forename: P
authors.initials: P
authors.lastname: Aalten
authors.forename: M Olde
authors.initials: MO
authors.lastname: Rikkert
authors.forename: M M
authors.initials: MM
authors.lastname: Verbeek
authors.forename: L
authors.initials: L
authors.lastname: Spiru
authors.forename: K
authors.initials: K
authors.lastname: Blennow
authors.forename: J Q
authors.initials: JQ
authors.lastname: Trojanowski
authors.forename: L M
authors.initials: LM
authors.lastname: Shaw
authors.forename: P J
authors.initials: PJ
authors.lastname: Visser
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid* / Q000523:psychology; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid*; D001007:Anxiety / Q000134:cerebrospinal fluid* / Q000453:epidemiology; D057565:Apathy; D015415:Biomarkers / Q000134:cerebrospinal fluid; D060825:Cognitive Dysfunction / Q000134:cerebrospinal fluid* / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D016001:Confidence Intervals; D003863:Depression / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007508:Irritable Mood / Q000502:physiology; D008297:Male; D009483:Neuropsychological Tests; D016017:Odds Ratio; D016875:tau Proteins / Q000134:cerebrospinal fluid*
chemical_list: D016229:Amyloid beta-Peptides; D015415:Biomarkers; D016875:tau Proteins