- Email: [email protected]
Subjective cognition and neuroticism, but not depressive symptoms, are associated with beta-amyloid deposition in the cognitively normal elderly
P780
P4-201
Poster Presentations: P4
SUBJECTIVE COGNITION AND NEUROTICISM, BUT NOT DEPRESSIVE SYMPTOMS, ARE ASSOCIATED WITH BETA-AMYLOID DEPOSITION IN THE COGNITIVELY NORMAL ELDERLY
Beth Snitz1, Ann Cohen2, Oscar Lopez1, Robert Nebes1, Julie Price1, Eric McDade1, Chester Mathis1, William Klunk1, 1University of Pittsburgh, Pittsburgh, Pennsylvania, United States; 2University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States. Contact e-mail: [email protected] Background: Subjective cognitive complaints (SCCs) are a risk factor for cognitive decline and progression to dementia. As well, the personality trait ‘Neuroticism’ (proneness to experience psychological distress) has been reported to increase risk for decline and Alzheimer’s disease (AD). Very few studies have examined SCCs and Neuroticism in relation to AD pathology, and none to our knowledge have considered them jointly and in cognitively normal older adults. Methods: We studied 59 participants aged 65 - 98 (mean 81.7, SD 7.7) years who completed PiB-PET imaging. Global PiB binding was computed as the average
SUVR (cerebellum reference) of 5 cortical regions plus the striatum. Participants were adjudicated as cognitively normal for age based on performance on a multi-domain neuropsychological battery. Self-report measures of SCCs and personality traits included the 25-item Cognitive Failures Questionnaire (CFQ), the 64-item Memory Functioning Questionnaire (MFQ), and the NEO-Five Factor Inventory (NEO-FFI). Current depressive symptoms were assessed with the Geriatric Depression Scale (GDS). Using linear regression models adjusting for age, education and sex, we evaluated associations between self-report behavioral measures and PiB-PET global SUVR as the outcome. Results: Global PiB SUVR was correlated with CFQ (r¼.32), with MFQ (r¼.30) and with Neuroticism (r¼.29) (p’s < .05, two-tailed), but not with GDS score. In independent, demographically adjusted models, both SCC measures and Neuroticism predicted global PiB binding (p’s .05), while GDS did not (p > .10). However, when entered simultaneously in the same model, CFQ and Neuroticism were no longer significant predictors. Similarly, MFQ and Neuroticism were no longer significant predictors when entered in the same model. Conclusions: Subjective cognitive complaints and trait Neuroticism are associated with brain a-beta deposition in cognitively normal elderly, although not independently of each other. A common emotional distress proneness factor may underlie both cognitive complaints and high Neuroticism scores and their relationship to a-beta. These findings are consistent with community studies of experienced psychological distress and risk for cognitive decline and AD progression. The use of self-report personality and subjective cognition measures may be of value as very early behavioral correlates of beta-amyloid in preclinical AD.
P4-202
SIX-YEAR PROSPECTIVE EVALUATION OF COGNITIVE PERFORMANCE IN ELDERLY PEOPLE WITH BIPOLAR DISORDER
Leticia Coelho1, Rodolfo Ladeira2, Ivan Aprahamian3, Orestes Forlenza4, Paula Nunes5, 1Institute of Psychiatric of Faculty of Medicine of University of S~ao Paulo, S~ao Paulo, Brazil; 2Psychiatry Institute, University of S~ao Paulo, S~ao Paulo, Brazil; 3Institute of Psychiatry - Hospital das Clınicas da FMUSP, S~ao Paulo, Brazil; 4Laboratory of Neuroscience - University of S~ao Paulo, S~ao Paulo, Brazil; 5University of S~ao Paulo, S~ao Paulo, Brazil. Contact e-mail: [email protected]
Figure. Associations between subjective cognition, trait Neuroticism and PiB retention in n¼59 cognitively normal older adults. A. Higher (worse) subjective cognition associated with higher global PiB retention (mean SUVR of six regions). B. Higher Neuroticism scores associated with higher global PiB retention. Strengths of associations are comparably sized.
Background: Bipolar disorder (BD) is associated with a higher prevalence of cognitive deficits, especially in executive function, attention and memory, which seem to be present even in euthymic or unmedicated patients. An increasing body of evidence shows that elderly adults diagnosed with BD have increased risk for dementia. However the characteristics of cognitive decline in this population are yet to be determined. This study aims to evaluate prospectively the cognitive function in non-demented elderly patients with BD. Methods: A total of 66 subjects aged 60 years were assessed at baseline, 3 and 6 years later; 29 had DSM-IV TR BD I or II disorder in euthymia and 37 were healthy control subjects (with similar age and no mood disorder). Cognitive performance was evaluated by the Cambridge Examination for Mental Disorders in the Elderly semi-structured interview, which yields scores for the Cambridge Cognitive Test (CAMCOG) and the Mini-Mental State Examination (MMSE). Results: In BD group, there was no significant decrease in scores from MMSE and CAMCOG after 3-year follow-up. However, within 6 years, a reduction in MMSE [from 25.7 (2.9) to 22.8 (4.0), P<001] and in CAMCOG [from 84.7 (13.5) to 76.7 (14.8), P ¼.001] was observed in this group of patients. Higher decline was found in the following CAMCOG subsets: orientation (P¼.018), language comprehension (P¼.007), recent memory (P ¼.003), praxis (P ¼.006) and abstraction (P ¼.027). Health controls showed no decline along the entire period. Conclusions: These results suggest a higher prevalence of cognitive impairment in elderly patients with BD. These results are consistent with epidemiological cross-sectional studies in BD. Further studies with a larger sample size and a longer follow-up period can complement the present study.
P4-201
Poster Presentations: P4
SUBJECTIVE COGNITION AND NEUROTICISM, BUT NOT DEPRESSIVE SYMPTOMS, ARE ASSOCIATED WITH BETA-AMYLOID DEPOSITION IN THE COGNITIVELY NORMAL ELDERLY
Beth Snitz1, Ann Cohen2, Oscar Lopez1, Robert Nebes1, Julie Price1, Eric McDade1, Chester Mathis1, William Klunk1, 1University of Pittsburgh, Pittsburgh, Pennsylvania, United States; 2University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States. Contact e-mail: [email protected] Background: Subjective cognitive complaints (SCCs) are a risk factor for cognitive decline and progression to dementia. As well, the personality trait ‘Neuroticism’ (proneness to experience psychological distress) has been reported to increase risk for decline and Alzheimer’s disease (AD). Very few studies have examined SCCs and Neuroticism in relation to AD pathology, and none to our knowledge have considered them jointly and in cognitively normal older adults. Methods: We studied 59 participants aged 65 - 98 (mean 81.7, SD 7.7) years who completed PiB-PET imaging. Global PiB binding was computed as the average
SUVR (cerebellum reference) of 5 cortical regions plus the striatum. Participants were adjudicated as cognitively normal for age based on performance on a multi-domain neuropsychological battery. Self-report measures of SCCs and personality traits included the 25-item Cognitive Failures Questionnaire (CFQ), the 64-item Memory Functioning Questionnaire (MFQ), and the NEO-Five Factor Inventory (NEO-FFI). Current depressive symptoms were assessed with the Geriatric Depression Scale (GDS). Using linear regression models adjusting for age, education and sex, we evaluated associations between self-report behavioral measures and PiB-PET global SUVR as the outcome. Results: Global PiB SUVR was correlated with CFQ (r¼.32), with MFQ (r¼.30) and with Neuroticism (r¼.29) (p’s < .05, two-tailed), but not with GDS score. In independent, demographically adjusted models, both SCC measures and Neuroticism predicted global PiB binding (p’s .05), while GDS did not (p > .10). However, when entered simultaneously in the same model, CFQ and Neuroticism were no longer significant predictors. Similarly, MFQ and Neuroticism were no longer significant predictors when entered in the same model. Conclusions: Subjective cognitive complaints and trait Neuroticism are associated with brain a-beta deposition in cognitively normal elderly, although not independently of each other. A common emotional distress proneness factor may underlie both cognitive complaints and high Neuroticism scores and their relationship to a-beta. These findings are consistent with community studies of experienced psychological distress and risk for cognitive decline and AD progression. The use of self-report personality and subjective cognition measures may be of value as very early behavioral correlates of beta-amyloid in preclinical AD.
P4-202
SIX-YEAR PROSPECTIVE EVALUATION OF COGNITIVE PERFORMANCE IN ELDERLY PEOPLE WITH BIPOLAR DISORDER
Leticia Coelho1, Rodolfo Ladeira2, Ivan Aprahamian3, Orestes Forlenza4, Paula Nunes5, 1Institute of Psychiatric of Faculty of Medicine of University of S~ao Paulo, S~ao Paulo, Brazil; 2Psychiatry Institute, University of S~ao Paulo, S~ao Paulo, Brazil; 3Institute of Psychiatry - Hospital das Clınicas da FMUSP, S~ao Paulo, Brazil; 4Laboratory of Neuroscience - University of S~ao Paulo, S~ao Paulo, Brazil; 5University of S~ao Paulo, S~ao Paulo, Brazil. Contact e-mail: [email protected]
Figure. Associations between subjective cognition, trait Neuroticism and PiB retention in n¼59 cognitively normal older adults. A. Higher (worse) subjective cognition associated with higher global PiB retention (mean SUVR of six regions). B. Higher Neuroticism scores associated with higher global PiB retention. Strengths of associations are comparably sized.
Background: Bipolar disorder (BD) is associated with a higher prevalence of cognitive deficits, especially in executive function, attention and memory, which seem to be present even in euthymic or unmedicated patients. An increasing body of evidence shows that elderly adults diagnosed with BD have increased risk for dementia. However the characteristics of cognitive decline in this population are yet to be determined. This study aims to evaluate prospectively the cognitive function in non-demented elderly patients with BD. Methods: A total of 66 subjects aged 60 years were assessed at baseline, 3 and 6 years later; 29 had DSM-IV TR BD I or II disorder in euthymia and 37 were healthy control subjects (with similar age and no mood disorder). Cognitive performance was evaluated by the Cambridge Examination for Mental Disorders in the Elderly semi-structured interview, which yields scores for the Cambridge Cognitive Test (CAMCOG) and the Mini-Mental State Examination (MMSE). Results: In BD group, there was no significant decrease in scores from MMSE and CAMCOG after 3-year follow-up. However, within 6 years, a reduction in MMSE [from 25.7 (2.9) to 22.8 (4.0), P<001] and in CAMCOG [from 84.7 (13.5) to 76.7 (14.8), P ¼.001] was observed in this group of patients. Higher decline was found in the following CAMCOG subsets: orientation (P¼.018), language comprehension (P¼.007), recent memory (P ¼.003), praxis (P ¼.006) and abstraction (P ¼.027). Health controls showed no decline along the entire period. Conclusions: These results suggest a higher prevalence of cognitive impairment in elderly patients with BD. These results are consistent with epidemiological cross-sectional studies in BD. Further studies with a larger sample size and a longer follow-up period can complement the present study.