FDG-PET and Neuropsychiatric Symptoms among Cognitively Normal Elderly Persons: The Mayo Clinic Study of Aging

Janina Krell-Roesch, Hanna Ruider, Val J. Lowe, Gorazd B. Stokin, Anna Pink, Rosebud O. Roberts, Michelle M. Mielke, David S. Knopman, Teresa J. Christianson, Mary M. MacHulda, Clifford R. Jack, Ronald C. Petersen, Yonas E. Geda

Research output: Contribution to journalArticlepeer-review

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; 1.233.64); the point estimate was further elevated for APOE ϵ4 carriers (OR=2.59; 1.006.69), 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.

Original languageEnglish (US)
Pages (from-to)1609-1616
Number of pages8
JournalJournal of Alzheimer's Disease
Volume53
Issue number4
DOIs
StatePublished - 2016
Externally publishedYes

Keywords

  • Agitation
  • Alzheimer's disease
  • Anxiety
  • Apathy
  • Cognitively normal persons
  • Depression
  • FDG-PET
  • Neuroimaging
  • Neuropsychiatric symptoms

ASJC Scopus subject areas

  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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