Depression and Anxiety Levels Increase Chronic Musculoskeletal Pain in Patients with Alzheimer’s Disease

Abstract Objective Individuals with probable Alzheimer’s disease (pAD) often have neuropsychiatric symptoms; however, the relationship of these symptoms and ApoE4 status is unclear. Recent research suggests gender moderates the relationship of ApoE4 to AD. We examined how ApoE4 genetic status and gender predict neuropsychiatric symptoms in older adults with pAD. Method Data from the National Alzheimer’s Coordinating Centers (NACC) was utilized in the present study. We included only individuals diagnosed with pAD with collaterals who were judged reliable by clinical NACC staff and who saw the participant at least three times per week. The selected sample (N = 6943) was 52% male; 85.6% White, 10.2% African American; and 7.5% Hispanic. Average age was 73 years. The Neuropsychiatric Inventory-Questionnaire, completed by the participant’s collateral, was used to assess symptoms. Analyses controlled for age and cognitive impairment as measured by the Mini-Mental State Examination. Results The presence of at least one ApoE4 allele predicted higher severity of delusions, p = .04. Males had higher severity of agitation, apathy, and irritability; females had higher delusions, depression, and anxiety, all p’s < .05. Gender moderated the relationship of ApoE4 with disinhibition, night disturbances, and appetite, all p’s < .05. In all three cases, for males, scores were higher for non-carriers than for ApoE4 carriers; however, for females, differences did not exist between carriers and non-carriers. Conclusions Differences between ApoE4 carriers and non-carriers as well as between genders are demonstrated, and evidence supports the hypothesis that gender and ApoE4 status interact to predict some pAD neuropsychiatric symptomatology.

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Increased Odds of Incident Alzheimer’s Disease and Related Dementias in Presence of Common Non-Cancer Chronic Pain Conditions in Appalachian Older Adults

Journal of Aging and Health ◽

10.1177/08982643211036219 ◽

2021 ◽

pp. 089826432110362

Author(s):

Sumaira Khalid ◽

Usha Sambamoorthi ◽

Amna Umer ◽

Christa L. Lilly ◽

Diane K. Gross ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Chronic Pain ◽

Sleep Disorders ◽

Large Population ◽

Sensitivity Analyses ◽

Depression And Anxiety ◽

Medicare Beneficiaries ◽

Risk Of Death ◽

Chronic Pain Conditions

Background There is a growing concern regarding the increasing prevalence of common non-cancer chronic pain conditions (NCPCs) and their possible association with Alzheimer’s disease and related dementias (ADRD). However, large population-based studies are limited, especially in Appalachian and other predominantly rural, underserved populations who suffer elevated prevalence of both NCPCs and known ADRD risk factors. Objectives We investigated the relation of NCPC to risk of incident ADRD in older Appalachian Medicare beneficiaries and explored the potential mediating effects of mood and sleep disorders. Methods Using a retrospective cohort design, we assessed the overall and cumulative association of common diagnosed NCPCs at baseline to incident ADRD in 161,573 elders ≥65 years, Medicare fee-for-service enrollees, 2013–2015. NCPCs and ADRD were ascertained using claims data. Additional competing risk for death analyses accounted for potential survival bias. Main Findings Presence of any NCPC at baseline was associated with significantly increased odds for incident ADRD after adjustment for covariates [adjusted odds ratio (AOR) = 1.26 (1.20, 1.32), p < .0001]. The magnitude and strength of this association increased significantly with rising burden of NCPCs at baseline [AOR for ≥4 vs. no NCPC = 1.65 (1.34, 2.03), p-trend = .01]. The addition of depression and anxiety, but not sleep disorders, modestly attenuated these associations [AORs for any NCPC and ≥4 NCPCs, respectively = 1.16 (1.10, 1.22) and 1.39 (1.13, 1.71)], suggesting a partial mediating role of mood impairment. Sensitivity analyses, multinomial logistic regressions accounting for risk of death, yielded comparable findings. Conclusion In this large cohort of older Appalachian Medicare beneficiaries, baseline NCPCs showed a strong, positive, dose–response relationship to odds for incident ADRD; this association appeared partially mediated by depression and anxiety. Further longitudinal research in this and other high-risk, rural populations are needed to evaluate the causal relation between NCPC and ADRD.

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Repetitive Transcranial Magnetic Stimulation as an Add-On Treatment for Cognitive Impairment in Alzheimer’s Disease and Its Impact on Self-Rated Quality of Life and Caregiver’s Burden

Brain Sciences ◽

10.3390/brainsci11060740 ◽

2021 ◽

Vol 11 (6) ◽

pp. 740

Author(s):

Juliana Teti Mayer ◽

Caroline Masse ◽

Gilles Chopard ◽

Magali Nicolier ◽

Matthieu Bereau ◽

...

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Transcranial Magnetic Stimulation ◽

Magnetic Stimulation ◽

Rating Scale ◽

Repetitive Transcranial Magnetic Stimulation ◽

Depression And Anxiety ◽

The Impact

Alzheimer’s disease (AD) is associated with progressive memory loss and decline in executive functions, as well as neuropsychiatric symptoms. Patients usually consider quality of life (QoL) and mood as more important for their health status than disease-specific physical and mental symptoms. In this open-label uncontrolled trial, 12 subjects diagnosed with AD underwent 10 sessions of repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (10 Hz, 20 min, 2000 pulses/day, 110% MT). Outcomes were measured before and 30 days after treatment. Our primary objective was to test the efficacy of rTMS as an add-on treatment for AD on the global cognitive function, assessed through the Mini-Mental State Examination (MMSE) and the Mattis Dementia Rating Scale (MDRS). As secondary objectives, the detailed effect on cognitive functions, depression and anxiety symptoms, QoL, and functionality in daily life activities were evaluated, as well as correlations between QoL and cognition, depression and anxiety scores. The treatment significantly enhanced semantic memory and reduced anxiety. Improvement of these features in AD could become an important target for treatment strategies. Although limited by its design, this trial may contribute with another perspective on the analysis and the impact of rTMS on AD.

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Neuroticism, depression, and anxiety traits exacerbate the state of cognitive impairment and hippocampal vulnerability to Alzheimer's disease

Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring ◽

10.1016/j.dadm.2017.05.002 ◽

2017 ◽

Vol 7 (1) ◽

pp. 107-114 ◽

Cited By ~ 11

Author(s):

Valérie Zufferey ◽

Alessia Donati ◽

Julius Popp ◽

Reto Meuli ◽

Jérôme Rossier ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

The State ◽

Depression And Anxiety

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Coherence of brain electrical activity: a quality of life indicator in Alzheimer’s disease?Coerência da atividade elétrica cerebral: indicador da qualidade de vida na doença de Alzheimer?

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20150035 ◽

2015 ◽

Vol 73 (5) ◽

pp. 396-401 ◽

Cited By ~ 9

Author(s):

Lineu Corrêa Fonseca ◽

Gloria M. A. S. Tedrus ◽

Ana Laura R. A. Rezende ◽

Heitor F. Giordano

Keyword(s):

Quality Of Life ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Rating Scales ◽

Quantitative Eeg ◽

Depression And Anxiety ◽

Neuropsychological Battery ◽

Functional Activities ◽

Electroencephalogram Eeg

Objective To investigate the relationships between quality of life (QOL) and clinical and electroencephalogram (EEG) aspects in patients with Alzheimer’s disease (AD). Method Twenty-eight patients with mild or moderate AD, 31 with Parkinson’s disease (PD), and 27 normal controls (NC) were submitted to: CERAD neuropsychological battery, Hamilton Depression and Anxiety Rating Scales, Functional Activities Questionnaire, QOL scale for patients with AD, and quantitative EEG measures. Results AD and PD patients had similar QOL (31.0 ± 5.8; 31.7 ± 4.8, respectively), worse than that of NC (37.5 ± 6.3). AD patients had lower global interhemispheric theta coherence (0.49 ± 0.04; 0.52 ± 0.05; 0.52 ± 0.05; respectively) than PD and NC. Multiple linear regression for QOL of AD patients revealed that global interhemispheric theta coherence, and Hamilton depression scores were significant factors (coefficients; 58.2 and -0.27, respectively; R2, 0.377). Conclusion Interhemispheric coherence correlates with QOL regardless of cognitive and functional variables and seems to be a neurophysiological indicator of QOL in AD patients.

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Sleep Treatment Improves Neuropsychological Symptoms and Reduces Blood Aβ42/pTau Protein in Alzheimer's Disease Patients: a Longitudinal Study

10.21203/rs.3.rs-138356/v1 ◽

2021 ◽

Author(s):

Benyi Li ◽

Haihua Huang ◽

Mingqiu Li ◽

Menglin Zhang ◽

Jiang Qiu ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Longitudinal Study ◽

Sleep Quality ◽

Sleep Disorders ◽

Sleep Disorder ◽

Amyloid Β Peptide ◽

Depression And Anxiety ◽

Self Reporting Questionnaire ◽

Sleep Treatment

Abstract Background: Amyloid β peptide-42 (Aβ42) and phosphorylated Tau on Threonine 181 (Tau-pT181) are the core biomarkers in Alzheimer’s disease. Accumulated evidence showed an aberrant elevation of these biomarkers due to sleep disturbance. However, it is not clear if improving sleep quality reduces Aβ42 and Tau-pT181 in Alzheimer’s disease patients.Methods: A longitudinal study was conducted on 126 patients with mild-moderate dementia due to Alzheimer’s disease. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Behavioral and neuropsychological assessment was conducted using multiple self-reporting questionnaire score systems. Aβ42 and Tau-pT181 levels in blood specimens were measured using an ELISA assay kit. All patients received Donepezil treatment for Alzheimer’s disease. Sleep disorders were individually managed with either medication or physical therapy according to their symptom categories.Results: Of the 126 cases, 93 (73.8%) patients were diagnosed with sleep disorders. The PSQI scores significantly correlated with depression and anxiety scores, as well as Aβ42 and Tau-pT181 levels. Also, a significant correlation was found among depression, anxiety, Aβ42 and Tau-pT181 in all patients. Sleep intervention drastically reduced PSQI score, as well as Aβ42 and Tau-pT181 levels, in parallel with improved cognition, deterioration and anxiety scores. Dementia and depression scores were improved only in patients who completely recovered (PSQI < 7) after sleep treatment. There was a 35.9% reduction of Aβ42 levels and a 32.8% reduction of Tau-pT181 levels in this subgroup of patients (56 cases). Conversely, the reduction extent was only 6.9% for Aβ42 and 12.2% for Tau-pT181 in patients who did not completely recover (PSQI ≥ 7 post treatment, 37 cases). Multiple logistic regression analysis revealed that Aβ42 level is the strongest risk factor for sleep disorder incidence and incomplete recovery after sleep treatment.Conclusion: Sleep quality score is associated with patient depression and anxiety status, as well as blood Aβ42 and Tau-pT181 levels. A complete recovery is critical for a full improvement of all behavioral and neuropsychological assessments, which is also associated with a deep reduction of Aβ42 and Tau-pT181 levels. Aβ42 level is a prognostic factor for a diagnosis of sleep disorder and treatment responsiveness.

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