Abstract Details

Title History of Psychiatric Disease Inversely Correlates with Age of Onset in Alzheimer’s Disease.

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) S19 - Aging and Dementia (2:24 PM-2:32 PM)

Poster/Presentation
Number 003

Objective To investigate the impact of psychiatric disease on Alzheimer’s Disease (AD).

Background Depression has been established as a risk factor in AD that may accelerate the development and disease course. Less studied are the effects of other mood disorders, psychotic disorders, and post-traumatic stress disorder (PTSD) on AD.

Design/Methods We screened 1500 AD patients from the UCSF Memory and Aging Center for history of psychiatric disorders: depression, anxiety, bipolar disorder, schizophrenia, and PTSD. We determined disease prevalence and investigated association with age at onset (AAO), demographics, typical AD risk factors (hypertension, hyperlipidemia, diabetes mellitus, education, and APOE4) as well as novel AD-associated factors, previously detailed (non-right-handedness, learning disability, autoimmune disease, and seizure history).

Results 43.3% (650/1500) had a history of depression, 32.3% (485/1500) anxiety, 1.2% (18/1500) bipolar disorder, 1% (15/1500) PTSD, and 0.4% (6/1500) schizophrenia. Those with depression or anxiety were significantly younger at AAO (2.1 and 3.0 yrs, respectively; p<0.001). Further, AAO reductions doubled with each additional psychiatric diagnosis: the presence of only one psychiatric disorder was associated with a 1.5 yr younger AD AAO, history of two psychiatric conditions led to a 3.3 yr decrease in AAO, and three or more diagnoses produced a 7.3 yr reduction in AAO (p<0.001). Depression and anxiety cohorts were more female and possessed fewer amounts of typical AD risk factors. The depression cohort possessed a significantly higher amount of autoimmune disease (p=0.01), whereas the anxiety cohort possessed a greater frequency of seizures (p=0.002).

Conclusions We find that diagnoses of depression and anxiety are inversely associated with AD AAO. Further, AAO differences compounded with increasing number of psychiatric diagnoses, suggesting each possess unique and additive effects on AD pathophysiology. We speculate that the presence of depression might reflect a greater burden of neuroinflammation and anxiety a greater degree of hyperexcitability, given associations with autoimmune disease and seizure.

Authors/Disclosures
Emily Eijansantos, MD (University of California, San Francisco) PRESENTER	Dr. Eijansantos has nothing to disclose.
	No disclosure on file
Jessica Deleon, MD (University of California, San Francisco)	Dr. Deleon has received research support from NIH NIDCD.
	No disclosure on file
Nicole K. Rogers, MD (MINE)	Dr. Rogers has nothing to disclose.
Rian L. Bogley (UCSF)	Mr. Bogley has nothing to disclose.
David Perry, MD	The institution of Dr. Perry has received research support from NIH/NIA.
Virginia Sturm, PhD	Dr. Sturm has nothing to disclose.
Howard J. Rosen, MD (UCSF)	Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eisai Pharmaceuticals. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. The institution of Dr. Rosen has received research support from NIH. The institution of Dr. Rosen has received research support from State of CA. Dr. Rosen has a non-compensated relationship as a Consultant with Alector that is relevant to AAN interests or activities. Dr. Rosen has a non-compensated relationship as a Consultant with Prevail Therapeutics that is relevant to AAN interests or activities. Dr. Rosen has a non-compensated relationship as a consultant with Alchemab that is relevant to AAN interests or activities.
Lea Grinberg	Lea Grinberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Curasen Inc. The institution of Lea Grinberg has received research support from NIH. The institution of Lea Grinberg has received research support from Eli Lilly. The institution of Lea Grinberg has received research support from BrightFouus. The institution of Lea Grinberg has received research support from Rainwater Charity Foundation.
William W. Seeley, MD	Dr. Seeley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG Council. Dr. Seeley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint Global Consulting. Dr. Seeley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BridgeBio. Dr. Seeley has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Seeley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lyterian Therapeutics. The institution of Dr. Seeley has received research support from NIH. The institution of Dr. Seeley has received research support from Rainwater Charitable Foundation. The institution of Dr. Seeley has received research support from Bluefield Project to Cure FTD. The institution of Dr. Seeley has received research support from Chan-Zuckerberg Initiative.
Bruce L. Miller, MD, FAAN (University of California, San Francisco)	Dr. Miller has nothing to disclose.
Gil D. Rabinovici, MD, FAAN (UCSF Memory & Aging Center)	Dr. Rabinovici has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alector. Dr. Rabinovici has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Norodisk. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for C2N. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Johnson & Joihnson. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Peerview. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medscape. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA. The institution of Dr. Rabinovici has received research support from NIH. The institution of Dr. Rabinovici has received research support from American College of Radiology. The institution of Dr. Rabinovici has received research support from Alzheimer's Association. The institution of Dr. Rabinovici has received research support from Rainwater Charitable Foundation. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Topic Chair, Course Director and teacher with AAN. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Grant reviewer with NIH. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Invited speaker with ANA.
Maria Luisa Gorno Tempini, MD, PhD (UCSF Memory and Aging Center)	The institution of Dr. Gorno Tempini has received research support from the NIH.
Zachary Miller, MD (UCSF Memory and Aging Center)	Dr. Miller has nothing to disclose.

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