• Leonie C P Banning, RamakersInez H G BIHGBDepartment of Psychiatry and Neuropsychology (LCPB, IHGBR, SK, FRJV, PA), Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, the Netherlands. Electronic address: i.ramakers@maastri, Sebastian Köhler, Esther E Bron, VerheyFrans R JFRJDepartment of Psychiatry and Neuropsychology (LCPB, IHGBR, SK, FRJV, PA), Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, the Netherlands., Peter Paul de Deyn, ClaassenJurgen A H RJAHRDepartment of Geriatric Medicine (JAHRC), Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands., Huiberdina L Koek, MiddelkoopHuub A MHAMDepartment of Neurology and Neuropsychology (HAMM), Leiden University Medical Center, Leiden, the Netherlands., Wiesje M van der Flier, Aad van der Lugt, Pauline Aalten, Alzheimer's Disease Neuroimaging Initiative, and Parelsnoer Institute Neurodegenerative Diseases study group.
• Department of Psychiatry and Neuropsychology (LCPB, IHGBR, SK, FRJV, PA), Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, the Netherlands.
• Am J Geriatr Psychiatry. 2020 Jul 1; 28 (7): 735-744.

ObjectiveTo investigate the relationship between Alzheimer's disease biomarkers and neuropsychiatric symptoms.MethodsData from two large cohort studies, the Dutch Parelsnoer Institute - Neurodegenerative Diseases and the Alzheimer's Disease Neuroimaging Initiative was used, including subjects with subjective cognitive decline (N = 650), mild cognitive impairment (N = 887), and Alzheimer's disease dementia (N = 626). Cerebrospinal fluid (CSF) levels of Aβ42, t-tau, p-tau, and hippocampal volume were associated with neuropsychiatric symptoms (measured with the Neuropsychiatric Inventory) using multiple logistic regression analyses. The effect of the Mini-Mental State Examination (as proxy for cognitive functioning) on these relationships was assessed with mediation analyses.ResultsAlzheimer's disease biomarkers were not associated with depression, agitation, irritability, and sleep disturbances. Lower levels of CSF Aβ42, higher levels of t- and p-tau were associated with presence of anxiety. Lower levels of CSF Aβ42 and smaller hippocampal volumes were associated with presence of apathy. All associations were mediated by cognitive functioning.ConclusionThe association between Alzheimer's disease pathology and anxiety and apathy is partly due to impairment in cognitive functioning.Copyright © 2020 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

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