Late-life onset psychotic symptoms and incident cognitive impairment in people without dementia: Modification by genetic risk for Alzheimer's disease.

Abstract

Introduction:

Late-life onset psychosis is associated with faster progression to dementia in cognitively normal people, but little is known about its relationship with cognitive impairment in advance of dementia.

Methods:

Clinical and genetic data from 2750 people ≥50 years of age without dementia were analyzed. Incident cognitive impairment was operationalized using the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and psychosis was rated using the Mild Behavioral Impairment Checklist (henceforth MBI-psychosis). The whole sample was analyzed before stratification on apolipoprotein E (APOE) ε4 status.

Results:

In Cox proportional hazards models, MBI-psychosis had a higher hazard for cognitive impairment relative to the No Psychosis group (hazard ratio [HR]: 3.6, 95% confidence interval [CI]: 2.2-6, p < 0.0001). The hazard for MBI-psychosis was higher in APOE ε4 carriers and there was an interaction between the two (HR for interaction: 3.4, 95% CI: 1.2-9.8, p = 0.02).

Discussion:

Psychosis assessment in the MBI framework is associated with incident cognitive impairment in advance of dementia. These symptoms may be particularly important in the context of APOE genotype.

• Authors: Byron Creese, Ryan Arathimos, Dag Aarsland, Clive Ballard, Helen Brooker, Adam Hampshire, Anne Corbett, Zahinoor Ismail
• Journal: Alzheimer's & dementia (New York, N. Y.) (Alzheimers Dement (N Y)) 2023 Apr-Jun Vol. 9 Issue 2 Pg. e12386 ISSN: 2352-8737 [Electronic] United States
• PMID: 37139261 (Publication Type: Journal Article)
• Copyright: © 2023 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals LLC on behalf of Alzheimer's Association.