DOI: 10.1002/dad2.70410 ISSN: 2352-8729

Regional amyloid accumulation, post‐traumatic distress, and intrusive symptoms in cognitively unimpaired older adults at risk for Alzheimer's

Eleni Palpatzis, Carmen M. Colceriu, Mahnaz Shekari, Muge Akinci, Marc Suárez‐Calvet, Oriol Grau‐Rivera, Gonzalo Sánchez‐Benavides, Juan Domingo Gispert, Eider M. Arenaza‐Urquijo,

Abstract

INTRODUCTION

In preclinical Alzheimer's disease (AD), early pathology may heighten vulnerability to psychiatric symptoms. We examined whether Aβ accumulation in cognitive‐emotional regions was associated with post‐pandemic psychiatric symptoms.

METHODS

This prospective cohort study included 115 cognitively unimpaired ALzheimer's and FAmilies participants (69 [60%] women, mean [SD] age 64.9 [4.8] years). Amyloid beta (Aβ) change was examined in anterior cingulate, posterior cingulate, superior parietal, medial orbitofrontal gyri, and insula using two [18F]flutemetamol positron emission tomography (PET) scans. Outcomes were pandemic‐related post‐traumatic distress (Impact of Events Scale Revised [IES‐R]; total, intrusive, avoidance, and hyperarousal symptoms) and anxious‐depressive symptoms (Hospital Anxiety and Depression Scale [HADS]; mean follow‐up: 3.62 years [SD = 0.68]). Linear regression and voxel‐wise analyses were performed.

RESULTS

Aβ accumulation across anterior cingulate ( β  = 40.29, p  = 0.036), posterior cingulate ( β  = 29.52, p  = 0.012), superior parietal ( β  = 35.58, p  = 0.036), and medial orbitofrontal gyri ( β  = 35.08, p  = 0.036) was associated with post‐pandemic intrusive symptoms only, independent of baseline anxious‐depressive symptoms.

DISCUSSION

Aβ accumulation in cognitive‐emotional regions may increase vulnerability to intrusive symptoms, highlighting their potential as early clinical markers in AD.

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