Elucidating the Link Between Anxiety/Depression and Alzheimer's Dementia in the Australian Imaging Biomarkers and Lifestyle (AIBL) Study

J Epidemiol Glob Health. 2024 Sep;14(3):1130-1141. doi: 10.1007/s44197-024-00266-w. Epub 2024 Jun 19.

Abstract

Background: The associations between mood disorders (anxiety and depression) and mild cognitive impairment (MCI) or Alzheimer's dementia (AD) remain unclear.

Methods: Data from the Australian Imaging, Biomarker & Lifestyle (AIBL) study were subjected to logistic regression to determine both cross-sectional and longitudinal associations between anxiety/depression and MCI/AD. Effect modification by selected covariates was analysed using the likelihood ratio test.

Results: Cross-sectional analysis was performed to explore the association between anxiety/depression and MCI/AD among 2,209 participants with a mean [SD] age of 72.3 [7.4] years, of whom 55.4% were female. After adjusting for confounding variables, we found a significant increase in the odds of AD among participants with two mood disorders (anxiety: OR 1.65 [95% CI 1.04-2.60]; depression: OR 1.73 [1.12-2.69]). Longitudinal analysis was conducted to explore the target associations among 1,379 participants with a mean age of 71.2 [6.6] years, of whom 56.3% were female. During a mean follow-up of 5.0 [4.2] years, 163 participants who developed MCI/AD (refer to as PRO) were identified. Only anxiety was associated with higher odds of PRO after adjusting for covariates (OR 1.56 [1.03-2.39]). However, after additional adjustment for depression, the association became insignificant. Additionally, age, sex, and marital status were identified as effect modifiers for the target associations.

Conclusion: Our study provides supportive evidence that anxiety and depression impact on the evolution of MCI/AD, which provides valuable epidemiological insights that can inform clinical practice, guiding clinicians in offering targeted dementia prevention and surveillance programs to the at-risk populations.

Keywords: Alzheimer’s dementia; Anxiety; Cross-sectional analysis; Depression; Longitudinal analysis; Mild cognitive impairment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease* / epidemiology
  • Alzheimer Disease* / psychology
  • Anxiety / epidemiology
  • Australia / epidemiology
  • Biomarkers
  • Cognitive Dysfunction* / diagnosis
  • Cognitive Dysfunction* / epidemiology
  • Cognitive Dysfunction* / etiology
  • Cognitive Dysfunction* / psychology
  • Cross-Sectional Studies
  • Depression* / epidemiology
  • Female
  • Humans
  • Life Style
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Risk Factors

Substances

  • Biomarkers