title: FDG-PET and Neuropsychiatric Symptoms among Cognitively Normal Elderly Persons: The Mayo Clinic Study of Aging.
abstract: One of the key research agenda of the field of aging is investigation of presymptomatic Alzheimer's disease (AD). Furthermore, abnormalities in brain glucose metabolism (as measured by FDG-PET) have been reported among cognitively normal elderly persons. However, little is known about the association of FDG-PET abnormalities with neuropsychiatric symptoms (NPS) in a population-based setting. Thus, we conducted a cross-sectional study derived from the ongoing population-based Mayo Clinic Study of Aging in order to examine the association between brain glucose metabolism and NPS among cognitively normal (CN) persons aged > 70 years. Participants underwent FDG-PET and completed the Neuropsychiatric Inventory Questionnaire (NPI-Q), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Cognitive classification was made by an expert consensus panel. We conducted multivariable logistic regression analyses to compute odds ratios (OR) and 95% confidence intervals after adjusting for age, sex, and education. For continuous variables, we used linear regression and Spearman rank-order correlations. Of 668 CN participants (median 78.1 years, 55.4% males), 205 had an abnormal FDG-PET (i.e., standardized uptake value ratio < 1.32 in AD-related regions). Abnormal FDG-PET was associated with depression as measured by NPI-Q (OR = 2.12; 1.23-3.64); the point estimate was further elevated for APOE ɛ4 carriers (OR = 2.59; 1.00-6.69), though marginally significant. Additionally, we observed a significant association between abnormal FDG-PET and depressive and anxiety symptoms when treated as continuous measures. These findings indicate that NPS, even in community-based samples, can be an important additional tool to the biomarker-based investigation of presymptomatic AD.
authors.affiliation: Mayo Clinic Translational Neuroscience and Aging Program, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Janina
authors.initials: J
authors.lastname: Krell-Roesch
authors.forename: Hanna
authors.initials: H
authors.lastname: Ruider
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Val J
authors.initials: VJ
authors.lastname: Lowe
authors.affiliation: International Clinical Research Center, Brno, Czech Republic.
authors.forename: Gorazd B
authors.initials: GB
authors.lastname: Stokin
authors.affiliation: Mayo Clinic Translational Neuroscience and Aging Program, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Pink
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.|Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Rosebud O
authors.initials: RO
authors.lastname: Roberts
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Mielke
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Knopman
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Teresa J
authors.initials: TJ
authors.lastname: Christianson
authors.affiliation: Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Machulda
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Jack
authors.affiliation: Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.|Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Petersen
authors.affiliation: Mayo Clinic Translational Neuroscience and Aging Program, Mayo Clinic, Scottsdale, AZ, USA.|Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.|Department of Psychiatry & Psychology, Mayo Clinic, Scottsdale, AZ, USA.|Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Yonas E
authors.initials: YE
authors.lastname: Geda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001007:Anxiety / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology; D001057:Apolipoproteins E / Q000235:genetics; D001921:Brain / Q000000981:diagnostic imaging*; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000150:complications; D003430:Cross-Sectional Studies; D003863:Depression / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology
chemical_list: D001057:Apolipoproteins E; D019788:Fluorodeoxyglucose F18
keywords: Agitation; Alzheimer’s disease; FDG-PET; anxiety; apathy; cognitively normal persons; depression; neuroimaging; neuropsychiatric symptoms