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ToolsClancy, Una, Radakovic, Ratko, Doubal, Fergus, Valdés Hernández, Maria del C., Muñoz Maniega, Susana, Taylor, Adele M., Corley, Janie, Chappell, Francesca M., Russ, Tom C., Cox, Simon R., Bastin, Mark E., Deary, Ian J. and Wardlaw, Joanna M. (2023) Are neuropsychiatric symptoms a marker of small vessel disease progression in older adults? Evidence from the Lothian Birth Cohort 1936. International Journal of Geriatric Psychiatry, 38 (1). ISSN 0885-6230
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Abstract
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.
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| Additional Information: | Data Availability Statement: Data are available from the corresponding author upon reasonable request. Funding Information: The LBC1936 study acknowledges the financial support of NHS Research Scotland (NRS), through Edinburgh Clinical Research Facility. This work was supported by Research Into Ageing (Programme grant 251; Wave 1), 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/18/5/34,216); 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. Funding Information: We thank the members of the Lothian Birth Cohort 1936, the LBC 1936 research team at the University of Edinburgh, Edinburgh Imaging and the radiographers at Edinburgh Imaging Facility. We thank Miles Welstead for providing information to describe participants who had their cognitive status assessed. The LBC1936 study acknowledges the financial support of NHS Research Scotland (NRS), through Edinburgh Clinical Research Facility. This work was supported by Research Into Ageing (Programme grant 251; Wave 1), 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/18/5/34,216); 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. |
| Uncontrolled Keywords: | ageing,apathy,cerebral small vessel disease,cognition,longitudinal studies,white matter hyperintensities,geriatrics and gerontology,psychiatry and mental health,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2717 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 13 Aug 2024 14:30 |
| Last Modified: | 25 Sep 2024 18:01 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/96241 |
| DOI: | 10.1002/gps.5855 |
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