Are neuropsychiatric symptoms a marker of small vessel disease progression in older adults? Evidence from the Lothian Birth Cohort 1936
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 hyperintensi...
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| Veröffentlicht in: | International journal of geriatric psychiatry 2023-01, Vol.38 (1), p.e5855-n/a |
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| creator | Clancy, Una Radakovic, Ratko Doubal, Fergus Hernández, Maria del C. Valdés Maniega, Susana Muñoz Taylor, Adele M. Corley, Janie Chappell, Francesca M. Russ, Tom C. Cox, Simon R. Bastin, Mark E. Deary, Ian J. Wardlaw, Joanna M. |
| description | 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.
Key points
Worse apathy at age 79 associates with greater progression of white matter hyperintensities (WMH) in the preceding 6 years.
In this population of community‐dwelling older adults, WMH progression is not associated with anxiety, depression, or subjective memory complaints.
Apathy has potential as a key clinical marker of SVD progression. |
| doi_str_mv | 10.1002/gps.5855 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10108049</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2753314758</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4005-6cb8e14467643f0bfc44594acb93cc82dac68e05e0514b0f51d1d48c19b5c9ff3</originalsourceid><addsrcrecordid>eNp1kVFr1TAYhoM43NkU_AUS8MabbkmbtMnV2A7bFA4oqNchTb-eZqZNTdIj5xfsby9zc0xBCATyPTz5Xl6E3lJyQgkpT7dzPOGC8xdoRYmUBaV1_RKtiBC8qMuKHKKjGG8IyTMqXqHDqmaSlE25QrfnAfAES_Bz3JvB6hSswXE_zsmPEWs86vADAvY9jqN2Du8gRnC4sxF0BDwHvw35yfoJ2wl712VYd4tL8Qxf7mwHkwHcBz_iNADe-JT_mPCFDWnAaz_4kDCVVf0aHfTaRXjzeB-j71eX39Yfi83n60_r801hGCE5jGkFUMbqpmZVT9reMMYl06aVlTGi7LSpBRCeD2Ut6TntaMeEobLlRvZ9dYzOHrzz0o7QGZhS0E7Nweage-W1VX9PJjuord8pSigRhMls-PBoCP7nAjGp0UYDzukJ_BJV2fCqoqzhIqPv_0Fv_BKmnC9TtZRCNuKZ0AQfY4D-aRtK1H29Kter7uvN6Lvn2z-Bf_rMQPEA_LIO9v8VqesvX38L7wDlpbDm</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2769989789</pqid></control><display><type>article</type><title>Are neuropsychiatric symptoms a marker of small vessel disease progression in older adults? Evidence from the Lothian Birth Cohort 1936</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Clancy, Una ; Radakovic, Ratko ; Doubal, Fergus ; Hernández, Maria del C. Valdés ; Maniega, Susana Muñoz ; Taylor, Adele M. ; Corley, Janie ; Chappell, Francesca M. ; Russ, Tom C. ; Cox, Simon R. ; Bastin, Mark E. ; Deary, Ian J. ; Wardlaw, Joanna M.</creator><creatorcontrib>Clancy, Una ; Radakovic, Ratko ; Doubal, Fergus ; Hernández, Maria del C. Valdés ; Maniega, Susana Muñoz ; Taylor, Adele M. ; Corley, Janie ; Chappell, Francesca M. ; Russ, Tom C. ; Cox, Simon R. ; Bastin, Mark E. ; Deary, Ian J. ; Wardlaw, Joanna M.</creatorcontrib><description>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.
Key points
Worse apathy at age 79 associates with greater progression of white matter hyperintensities (WMH) in the preceding 6 years.
In this population of community‐dwelling older adults, WMH progression is not associated with anxiety, depression, or subjective memory complaints.
Apathy has potential as a key clinical marker of SVD progression.</description><identifier>ISSN: 0885-6230</identifier><identifier>EISSN: 1099-1166</identifier><identifier>DOI: 10.1002/gps.5855</identifier><identifier>PMID: 36490272</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Age ; Aged ; ageing ; Anxiety ; Apathy ; Birth Cohort ; cerebral small vessel disease ; Cerebral Small Vessel Diseases - diagnostic imaging ; Clinical trials ; cognition ; Dementia disorders ; Disease Progression ; Emotional behavior ; Geriatric psychiatry ; Humans ; Longitudinal studies ; Magnetic Resonance Imaging ; Memory ; Mental depression ; Mental disorders ; Older people ; Regression analysis ; Substantia alba ; Vascular diseases ; White Matter - diagnostic imaging ; white matter hyperintensities</subject><ispartof>International journal of geriatric psychiatry, 2023-01, Vol.38 (1), p.e5855-n/a</ispartof><rights>2022 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4005-6cb8e14467643f0bfc44594acb93cc82dac68e05e0514b0f51d1d48c19b5c9ff3</cites><orcidid>0000-0002-8062-7537</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fgps.5855$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fgps.5855$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36490272$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clancy, Una</creatorcontrib><creatorcontrib>Radakovic, Ratko</creatorcontrib><creatorcontrib>Doubal, Fergus</creatorcontrib><creatorcontrib>Hernández, Maria del C. Valdés</creatorcontrib><creatorcontrib>Maniega, Susana Muñoz</creatorcontrib><creatorcontrib>Taylor, Adele M.</creatorcontrib><creatorcontrib>Corley, Janie</creatorcontrib><creatorcontrib>Chappell, Francesca M.</creatorcontrib><creatorcontrib>Russ, Tom C.</creatorcontrib><creatorcontrib>Cox, Simon R.</creatorcontrib><creatorcontrib>Bastin, Mark E.</creatorcontrib><creatorcontrib>Deary, Ian J.</creatorcontrib><creatorcontrib>Wardlaw, Joanna M.</creatorcontrib><title>Are neuropsychiatric symptoms a marker of small vessel disease progression in older adults? Evidence from the Lothian Birth Cohort 1936</title><title>International journal of geriatric psychiatry</title><addtitle>Int J Geriatr Psychiatry</addtitle><description>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.
Key points
Worse apathy at age 79 associates with greater progression of white matter hyperintensities (WMH) in the preceding 6 years.
In this population of community‐dwelling older adults, WMH progression is not associated with anxiety, depression, or subjective memory complaints.
Apathy has potential as a key clinical marker of SVD progression.</description><subject>Age</subject><subject>Aged</subject><subject>ageing</subject><subject>Anxiety</subject><subject>Apathy</subject><subject>Birth Cohort</subject><subject>cerebral small vessel disease</subject><subject>Cerebral Small Vessel Diseases - diagnostic imaging</subject><subject>Clinical trials</subject><subject>cognition</subject><subject>Dementia disorders</subject><subject>Disease Progression</subject><subject>Emotional behavior</subject><subject>Geriatric psychiatry</subject><subject>Humans</subject><subject>Longitudinal studies</subject><subject>Magnetic Resonance Imaging</subject><subject>Memory</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Older people</subject><subject>Regression analysis</subject><subject>Substantia alba</subject><subject>Vascular diseases</subject><subject>White Matter - diagnostic imaging</subject><subject>white matter hyperintensities</subject><issn>0885-6230</issn><issn>1099-1166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kVFr1TAYhoM43NkU_AUS8MabbkmbtMnV2A7bFA4oqNchTb-eZqZNTdIj5xfsby9zc0xBCATyPTz5Xl6E3lJyQgkpT7dzPOGC8xdoRYmUBaV1_RKtiBC8qMuKHKKjGG8IyTMqXqHDqmaSlE25QrfnAfAES_Bz3JvB6hSswXE_zsmPEWs86vADAvY9jqN2Du8gRnC4sxF0BDwHvw35yfoJ2wl712VYd4tL8Qxf7mwHkwHcBz_iNADe-JT_mPCFDWnAaz_4kDCVVf0aHfTaRXjzeB-j71eX39Yfi83n60_r801hGCE5jGkFUMbqpmZVT9reMMYl06aVlTGi7LSpBRCeD2Ut6TntaMeEobLlRvZ9dYzOHrzz0o7QGZhS0E7Nweage-W1VX9PJjuord8pSigRhMls-PBoCP7nAjGp0UYDzukJ_BJV2fCqoqzhIqPv_0Fv_BKmnC9TtZRCNuKZ0AQfY4D-aRtK1H29Kter7uvN6Lvn2z-Bf_rMQPEA_LIO9v8VqesvX38L7wDlpbDm</recordid><startdate>202301</startdate><enddate>202301</enddate><creator>Clancy, Una</creator><creator>Radakovic, Ratko</creator><creator>Doubal, Fergus</creator><creator>Hernández, Maria del C. Valdés</creator><creator>Maniega, Susana Muñoz</creator><creator>Taylor, Adele M.</creator><creator>Corley, Janie</creator><creator>Chappell, Francesca M.</creator><creator>Russ, Tom C.</creator><creator>Cox, Simon R.</creator><creator>Bastin, Mark E.</creator><creator>Deary, Ian J.</creator><creator>Wardlaw, Joanna M.</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8062-7537</orcidid></search><sort><creationdate>202301</creationdate><title>Are neuropsychiatric symptoms a marker of small vessel disease progression in older adults? Evidence from the Lothian Birth Cohort 1936</title><author>Clancy, Una ; Radakovic, Ratko ; Doubal, Fergus ; Hernández, Maria del C. Valdés ; Maniega, Susana Muñoz ; Taylor, Adele M. ; Corley, Janie ; Chappell, Francesca M. ; Russ, Tom C. ; Cox, Simon R. ; Bastin, Mark E. ; Deary, Ian J. ; Wardlaw, Joanna M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4005-6cb8e14467643f0bfc44594acb93cc82dac68e05e0514b0f51d1d48c19b5c9ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Age</topic><topic>Aged</topic><topic>ageing</topic><topic>Anxiety</topic><topic>Apathy</topic><topic>Birth Cohort</topic><topic>cerebral small vessel disease</topic><topic>Cerebral Small Vessel Diseases - diagnostic imaging</topic><topic>Clinical trials</topic><topic>cognition</topic><topic>Dementia disorders</topic><topic>Disease Progression</topic><topic>Emotional behavior</topic><topic>Geriatric psychiatry</topic><topic>Humans</topic><topic>Longitudinal studies</topic><topic>Magnetic Resonance Imaging</topic><topic>Memory</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Older people</topic><topic>Regression analysis</topic><topic>Substantia alba</topic><topic>Vascular diseases</topic><topic>White Matter - diagnostic imaging</topic><topic>white matter hyperintensities</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Clancy, Una</creatorcontrib><creatorcontrib>Radakovic, Ratko</creatorcontrib><creatorcontrib>Doubal, Fergus</creatorcontrib><creatorcontrib>Hernández, Maria del C. Valdés</creatorcontrib><creatorcontrib>Maniega, Susana Muñoz</creatorcontrib><creatorcontrib>Taylor, Adele M.</creatorcontrib><creatorcontrib>Corley, Janie</creatorcontrib><creatorcontrib>Chappell, Francesca M.</creatorcontrib><creatorcontrib>Russ, Tom C.</creatorcontrib><creatorcontrib>Cox, Simon R.</creatorcontrib><creatorcontrib>Bastin, Mark E.</creatorcontrib><creatorcontrib>Deary, Ian J.</creatorcontrib><creatorcontrib>Wardlaw, Joanna M.</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Clancy, Una</au><au>Radakovic, Ratko</au><au>Doubal, Fergus</au><au>Hernández, Maria del C. Valdés</au><au>Maniega, Susana Muñoz</au><au>Taylor, Adele M.</au><au>Corley, Janie</au><au>Chappell, Francesca M.</au><au>Russ, Tom C.</au><au>Cox, Simon R.</au><au>Bastin, Mark E.</au><au>Deary, Ian J.</au><au>Wardlaw, Joanna M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are neuropsychiatric symptoms a marker of small vessel disease progression in older adults? Evidence from the Lothian Birth Cohort 1936</atitle><jtitle>International journal of geriatric psychiatry</jtitle><addtitle>Int J Geriatr Psychiatry</addtitle><date>2023-01</date><risdate>2023</risdate><volume>38</volume><issue>1</issue><spage>e5855</spage><epage>n/a</epage><pages>e5855-n/a</pages><issn>0885-6230</issn><eissn>1099-1166</eissn><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.
Key points
Worse apathy at age 79 associates with greater progression of white matter hyperintensities (WMH) in the preceding 6 years.
In this population of community‐dwelling older adults, WMH progression is not associated with anxiety, depression, or subjective memory complaints.
Apathy has potential as a key clinical marker of SVD progression.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36490272</pmid><doi>10.1002/gps.5855</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-8062-7537</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0885-6230 |
| ispartof | International journal of geriatric psychiatry, 2023-01, Vol.38 (1), p.e5855-n/a |
| issn | 0885-6230 1099-1166 |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Age Aged ageing Anxiety Apathy Birth Cohort cerebral small vessel disease Cerebral Small Vessel Diseases - diagnostic imaging Clinical trials cognition Dementia disorders Disease Progression Emotional behavior Geriatric psychiatry Humans Longitudinal studies Magnetic Resonance Imaging Memory Mental depression Mental disorders Older people Regression analysis Substantia alba Vascular diseases White Matter - diagnostic imaging white matter hyperintensities |
| title | Are neuropsychiatric symptoms a marker of small vessel disease progression in older adults? Evidence from the Lothian Birth Cohort 1936 |
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