Psychiatric symptoms of Alzheimer’s disease

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Lund University, April 19th

For a long time, these symptoms were not known Whether it occurs due to tissue changes in the brain or represents a psychological response to cognitive symptoms. A study from Lund University in Sweden provides new insights and is published in the journal Biological Psychiatry.

Research published in Biological Psychiatry on January 28, 2022 (latest impact factor: 13.p>p8) >

Cognitive symptoms combined with elevated levels of certain proteins form the basis for the diagnosis of Alzheimer’s disease. At the same time, researchers and doctors have recognized over the past decade that changes in mood and behavior are often early signs of the disease. However, these symptoms have not received the same scientific attention as cognitive symptoms.

Now, researchers at Lund University have investigated the complex relationship between psychological symptoms, Alzheimer’s disease proteins and cognitive symptoms. This was done within the framework of the internationally renowned BioFINDER study, led by Professor Oskar Hansson.

Professor Oskar Hansson

Biological and reliable early identification of neurodegenerative diseases Biomarkers For Identifying Neurodegenerative Disorders Early and Reliably (BioFINDER) research aims to discover key mechanisms of Alzheimer’s, Parkinson’s and other neurodegenerative diseases to develop early and accurate Diagnostic tests that identify new therapeutic targets and help understand the connections between different pathologies and clinical symptoms.

The study surveyed 356 people over the age of 65. People without any cognitive symptoms at the start of the study. In addition to analyzing levels of Alzheimer’s disease proteins beta-amyloid and phosphorylated tau in cerebrospinal fluid, participants’ levels of anxiety, apathy, and overall cognitive function were also analyzed every two years Evaluate once. Researchers followed participants for 8 years.

When the data were analyzed, the researchers found that there was a link between elevated beta-amyloid levels at the start of the study and future development of anxiety and apathy. There is an obvious connection.

The study’s lead author, physician Maurits Johansson, explained: “Alzheimer’s disease affects large parts of the brain, including the areas that control our emotional lives. Our study showed that psychiatric symptoms, like cognitive symptoms, are primarily a direct consequence of underlying changes in the brain, which are due to increased beta-amyloid levels.”

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The researchers further demonstrated that β-amyloid mainly drives the development of apathy through direct action, and apathy only Secondary to cognitive decline to a limited extent. Anxiety is not associated with cognitive changes.

“These findings thus disprove the notion , that the early changes in emotion and motivation in Alzheimer’s disease are primarily psychological responses to cognitive decline. Instead, the findings suggest that, at least for apathy and anxiety, these occur due to the pathological accumulation of beta-amyloid,” explains Prof. Oskar Hansson.

“Our findings suggest that psychiatric symptoms of Alzheimer’s disease can serve as surrogate outcomes for treatment trials. Ultimately, this could lead to more efficient study designs,” he continued.

“A previous study by BioFINDER showed that no Anxiety or apathy in older adults with dementia symptoms may indicate an increased risk of future cognitive impairment. As a next step, research is needed to elucidate how these symptoms contribute to an established clinical diagnosis in the early stages of the disease, perhaps even before cognition is affected,” they concluded.

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Lund University

Psychiatric symptoms in Alzheimer´s disease


Maurits Johansson, Erik Stomrud, Per Mårten Johansson, Anna Svenningsson, Sebastian Palmqvist, Shorena Janelidze , Danielle van Westen, Niklas Mattsson-Carlgren, Oskar Hansson. Development of Apathy, Anxiety, and Depression in Cognitively Unimpaired Older Adults: Effects of Alzheimer’s Disease Pathology and Cognitive Decline. Biological Psychiatry, 2022; DOI: 10.1016/j.biopsych.2022.01.012


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