May Alzheimer’s start soon for people with anxiety, history of depression

A history of anxiety or depression was significantly associated with age at the onset of Alzheimer’s disease, a retrospective study suggested.

People with Alzheimer’s disease who had a diagnosis of anxiety in the past were 3 years younger than other Alzheimer’s patients when they developed the disease, Zachary Miller, MD, University of California San Francisco (UCSF), reported, and co-authors.

Patients with a history of depression were 2 years younger at the onset of Alzheimer’s, they said in a summary released before the 2021 annual meeting of the American Academy of Neurology.

The findings were based on 1,500 patients with Alzheimer’s disease from the UCSF Center for Memory and Aging who were screened for past psychiatric disorders, including depression, anxiety, dementia. bipolar disorder, schizophrenia, and post-traumatic stress disorder (PTSD). Researchers assessed typical Alzheimer’s risk factors – hypertension, hyperlipidemia, diabetes, education, and APOE4 status – as well as Alzheimer’s-related factors such as left-handedness, learning disabilities, autoimmune diseases, and a history of seizures.

“We are continuing to study these findings in more depth.” Miller said. “We have reason to believe that we have verified our key findings in a large side database. out of Alzheimer’s patients from the National Alzheimer’s Coordination Center, which we hope to discuss in more depth through our presentation ”at AAN’s annual meeting, he said. MedPage today.

It is “largely established that some mental illnesses, particularly depression and anxiety, are in some way linked to mental decline and possibly depression,” said Claire Sexton, DPhil, director of scientific programs and an outreach at the Alzheimer’s Society in Chicago, which was not involved in the study.

“There are still questions, however, as to whether the mental changes are leading to the mental conditions, or whether the mental conditions are contributing to the mental changes,” Sexton said. MedPage today. “Both seem to be somewhat true, but more research is needed to clarify these relationships.”

Of the Alzheimer’s patients in the UCSF study, 43.3% had a history of depression, 32.3% had anxiety, 1.2% had bipolar disorder, 1% had PTSD, and 0.4% had schizophrenia. Patients with depression or anxiety were significantly younger at the onset of Alzheimer’s age by 2.1 and 3.0 years, respectively, compared with those without (P.<0.001).

Decrease in age at the onset of Alzheimer’s was doubled with each additional psychiatric diagnosis: a history of one psychiatric disorder was linked to Alzheimer’s beginning 1.5 years earlier, two psychiatric disorders to 3.3 a year earlier, and three or more psychiatric disorders up to 7.3 years earlier (P.<0.001).

People with depression or a history of anxiety were more likely to be women and had fewer risk factors for Alzheimer’s disease. The group with a diagnosis of depression had a much higher incidence of autoimmune diseases in the past (P.= 0.01). The group concerned was more likely to have a history of seizures (P.= 0.002).

The findings suggest that psychiatric disorders “each possess specific and contributing effects on the pathophysiology of Alzheimer’s disease,” the researchers said.

“While this link between depression and autoimmune disease, and seizures and anxiety is very early, we recognize that the display of depression in some people may be a burden. increased neuroinflammation, “Miller said.” The presence of anxiety may indicate a greater degree of neuronal hyperexcitability, where the networks in the brain are overridden, which may open up new therapeutic targets. for the prevention of depression. “

The limitation of the study is that data were obtained from a specialized tertiary memory care center by retrospective card review.

Last updated February 24, 2021