The number of deaths from this disease has more than doubled since 2000
Anxiety is associated with a higher rate of progression from mild cognitive impairment to Alzheimer’s disease, according to a study presented at the annual meeting of the Radiological Society of North America (RSNA).
Alzheimer’s represents a major crisis in the health public worldwide. The number of deaths from this disease has more than doubled since 2000, and it is currently the fifth leading cause of death among people 65 and older in the United States.
Many people with Alzheimer’s first experience mild cognitive decline, a decline in cognitive abilities such as memory and thinking skills that is faster than is normally associated with aging. Anxiety has been observed frequently in patients with mild cognitive impairment, although its role in the progression of the disease is not well understood.
“We know that the loss of volume in certain areas of the brain is a factor that predicts the progression of Alzheimer’s disease. In this study, we wanted to see if anxiety had an effect on the structure of the brain, or if the effect of anxiety it was independent of the structure of the brain to favor the progression of the disease “, explains the study’s lead author, Maria Vittoria Spampinato, professor of radiology at the Medical University of South Carolina in Charleston (United States).
The study group included 339 patients, with a mean age of 72 years, from the Alzheimer’s Disease Neuroimaging Initiative 2 cohort. Each person had a baseline diagnosis of mild cognitive impairment; 72 progressed to Alzheimer’s disease while 267 remained stable.
The researchers performed MRIs of the brain to determine the baseline volumes of the hippocampus and entorhinal cortex, two important areas for memory formation. They also tested for the presence of the APOE4 allele, the most prevalent genetic risk factor in Alzheimer’s disease. Anxiety was measured with established clinical studies.
As expected, patients progressing to Alzheimer’s had significantly smaller volumes in the hippocampus and entorhinal cortex and a higher frequency of the APOE4 allele. Most notably, however, the researchers found that anxiety was independently associated with cognitive decline.
“Patients with mild cognitive impairment with symptoms of anxiety developed Alzheimer’s disease faster than individuals without anxiety, regardless of whether they had a genetic risk factor for Alzheimer’s disease or loss of brain volume,” details the first author of the study, Jenny L. Ulber.
The relationship between anxiety symptoms and a more rapid progression of Alzheimer’s disease presents an opportunity to improve the assessment and management of patients with early mild cognitive impairment, according to the researchers.
“We need to better understand the association between anxiety disorders and cognitive decline. We don’t yet know if anxiety is a symptom – in other words, their memory is worsening and they become anxious – or if anxiety contributes to cognitive decline. If we were able in the future to find that anxiety is actually causing the progression, then we should more aggressively review anxiety disorders in the elderly, “concludes Spampinato.