Association of anxiety with vascular risk factors in memory clinic patients with MCI and Alzheimer's dementia. (31st December 2021)

• Record Type: Journal Article
• Authors: Razavian, Narges; Dodson, John; Horwitz, Leora; Aphinyanaphongs, Yindalon; Wisniewski, Thomas; Masurkar, Arjun V
• Is Part Of: Alzheimer's & dementia. Volume 17(2021)Supplement 6
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-12-31
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.056623
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Anxiety is increasingly recognized as an early neuropsychiatric symptom in Alzheimer's disease (AD) that portends faster progression. The etiology of anxiety in AD and the mechanism of this faster progression are unclear. Vascular risk factors independently associate with anxiety and dementia, and thus may play an important role in AD‐related anxiety. We aimed to study the prevalence of vascular risk factors in memory clinic patients with and without anxiety at the mild cognitive impairment (MCI) and AD dementia stages. Method: The cohort included patients aged ≥ 65 years who were evaluated at the NYU Langone Barlow Center for Memory Evaluation and Treatment between January 1, 2015 and June 24, 2019. Analysis was limited to patients who received a diagnosis of mild cognitive impairment (MCI) or Alzheimer's dementia (AD). At each stage, the cohort was divided into those with and without a coded diagnosis related to anxiety. Outcomes and clinical variables were based on electronic health records. Definitions for AD, MCI, anxiety, and vascular risk factors are shown in Tables 1‐2. Result: 2046 and 1594 patients were included in the MCI and AD cohorts, with anxiety prevalence of 26% and 20% in each cohort respectively. Characteristics of MCI and AD patients with and without anxiety are reported in Table 3. The rates of key cardio‐ and cerebrovascular risk factors were of increased frequency in anxious vs. non‐anxious patients in both MCI and AD cohorts: hypertension, hyperlipidemia, myocardial infarction, atrial fibrillation, ischemic heart disease, heart failure, and diabetes mellitus. Moreover, these differences were amplified in the dementia stage compared to the MCI stage. Peripheral vascular disease, stroke, and sleep apnea differences were unique to the dementia stage. Conclusion: These results suggest that vascular risk factors could play a critical role in the relationship between anxiety and AD. This relationship strengthens as AD progresses from prodromal to dementia stage, and also involves additional factors. Further characterization of these relationships and their mechanisms may uncover novel pathways to manage AD‐related neuropsychiatric symptoms and modify AD progression.