TY - JOUR
T1 - Are neuropsychiatric symptoms a marker of small vessel disease progression in older adults?
T2 - Evidence from the Lothian Birth Cohort 1936
AU - Clancy, Una
AU - Radakovic, Ratko
AU - Doubal, Fergus
AU - Hernández, Maria Del C. Valdés
AU - Maniega, Susana Muñoz
AU - Taylor, Adele M
AU - Corley, Janie
AU - Chappell, Francesca M
AU - Russ, Tom C
AU - Cox, Simon R.
AU - Bastin, Mark E
AU - Deary, Ian J.
AU - Wardlaw, Joanna M.
N1 - Age UK (Disconnected Mind Programme grant), and the UK's Medical
Research Council (G0701120; G1001245, MR/M013111/1, MR/R024065/1). IJD is supported by the University of Edinburgh Centre for Cognitive Ageing and
Cognitive Epidemiology which is funded by the Medical Research Council and
the Biotechnology and Biological Sciences Research Council (Grant No.
MR/K026992/1). SRC and IJD were also supported by a National Institutes of
Health (NIH) research grant R01AG054628. UC is funded by a Chief Scientist
Office of Scotland Clinical Academic Fellowship (CAF/18/08); Stroke Association
Princess Margaret Research Development Fellowship (2018). MCVH is funded
by the Row Fogo Charitable Trust (BROD.FID3668413). TCR is a member of the
Alzheimer Scotland Dementia Research Centre supported by Alzheimer
Scotland. FND is funded by Stroke Association Garfield Weston Foundation
Senior Clinical Lectureship (TSALECT 2015/04); NHS Research Scotland. JMW
receives funding from the UK Dementia Research Institute which receives its
funding from DRI Ltd, funded by the UK MRC, Alzheimer’s Society and
Alzheimer’s Research UK; the Fondation Leducq Network for the Study of
Perivascular Spaces in Small Vessel Disease (16 CVD 05), the BHF Edinburgh
Centre for Research Excellence (RE/18/5/34216); the Row Fogo Charitable Trust
Centre for Research into Aging and the Brain; and the Scottish Funding Council
through the Scottish Imaging Network, A Platform for Scientific Excellence
(SINAPSE) Collaboration.
PY - 2023/1
Y1 - 2023/1
N2 - BACKGROUND: Neuropsychiatric symptoms could form part of an early cerebral small vessel disease prodrome that is detectable before stroke or dementia onset. We aimed to identify whether apathy, depression, anxiety, and subjective memory complaints associate with longitudinal white matter hyperintensity (WMH) progression. METHODS: Community-dwelling older adults from the observational Lothian Birth Cohort 1936 attended three visits at mean ages 73, 76, and 79 years, repeating MRI, Mini-Mental State Examination, neuropsychiatric (Dimensional Apathy Scale, Hospital Anxiety and Depression Scale), and subjective memory symptoms. We ran regression and mixed-effects models for symptoms and normalised WMH volumes (cube root of WMH:ICV × 10). RESULTS: At age 73, 76, and 79, m = 672, n = 476, and n = 382 participants attended MRI respectively. Worse apathy at age 79 was associated with WMH volume increase (β = 0.27, p = 0.04) in the preceding 6 years. A 1SD increase in apathy score at age 79 associated with a 0.17 increase in WMH (β = 0.17 normalised WMH percent ICV, p = 0.009). In apathy subscales, executive (β = 0.13, p = 0.05) and emotional (β = 0.13, p = 0.04) scores associated with increasing WMH more than initiation scores (β = 0.11, p = 0.08). Increasing WMH also associated with age (β = 0.40, p = 0.002) but not higher depression (β = -0.01, p = 0.78), anxiety (β = 0.05, p = 0.13) scores, or subjective memory complaints (β = 1.12, p = 0.75). CONCLUSIONS: Apathy independently associates with preceding longitudinal WMH progression, while depression, anxiety, and subjective memory complaints do not. Patients with apathy should be considered for enrolment to small vessel disease trials.
AB - BACKGROUND: Neuropsychiatric symptoms could form part of an early cerebral small vessel disease prodrome that is detectable before stroke or dementia onset. We aimed to identify whether apathy, depression, anxiety, and subjective memory complaints associate with longitudinal white matter hyperintensity (WMH) progression. METHODS: Community-dwelling older adults from the observational Lothian Birth Cohort 1936 attended three visits at mean ages 73, 76, and 79 years, repeating MRI, Mini-Mental State Examination, neuropsychiatric (Dimensional Apathy Scale, Hospital Anxiety and Depression Scale), and subjective memory symptoms. We ran regression and mixed-effects models for symptoms and normalised WMH volumes (cube root of WMH:ICV × 10). RESULTS: At age 73, 76, and 79, m = 672, n = 476, and n = 382 participants attended MRI respectively. Worse apathy at age 79 was associated with WMH volume increase (β = 0.27, p = 0.04) in the preceding 6 years. A 1SD increase in apathy score at age 79 associated with a 0.17 increase in WMH (β = 0.17 normalised WMH percent ICV, p = 0.009). In apathy subscales, executive (β = 0.13, p = 0.05) and emotional (β = 0.13, p = 0.04) scores associated with increasing WMH more than initiation scores (β = 0.11, p = 0.08). Increasing WMH also associated with age (β = 0.40, p = 0.002) but not higher depression (β = -0.01, p = 0.78), anxiety (β = 0.05, p = 0.13) scores, or subjective memory complaints (β = 1.12, p = 0.75). CONCLUSIONS: Apathy independently associates with preceding longitudinal WMH progression, while depression, anxiety, and subjective memory complaints do not. Patients with apathy should be considered for enrolment to small vessel disease trials.
KW - ageing
KW - apathy
KW - cerebral small vessel disease
KW - cognition
KW - longitudinal studies
KW - white matter hyperintensities
U2 - 10.1002/gps.5855
DO - 10.1002/gps.5855
M3 - Article
VL - 38
JO - International Journal of Geriatric Psychiatry
JF - International Journal of Geriatric Psychiatry
SN - 0885-6230
IS - 1
M1 - e5855
ER -