Specific Association of Worry With Amyloid-ß But Not Tau in Cognitively Unimpaired Older Adults.

OBJECTIVE: Anxiety disorders and subsyndromal anxiety symptoms are highly prevalent in late life. Recent studies support that anxiety may be a neuropsychiatric symptom during preclinical Alzheimer's disease (AD) and that higher anxiety is associated with more rapid cognitive decline and progression to cognitive impairment. However, the associations of specific anxiety symptoms with AD pathologies and with co-occurring subjective and objective cognitive changes have not yet been established. METHODS: Baseline data from the A4 and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration studies were analyzed. Older adult participants (n = 4,486) underwent assessments of anxiety (State-Trait Anxiety Inventory-6 item version [STAI]), and cerebral amyloid-beta (Aß; 18F-florbetapir) PET and a subset underwent tau (18F-flortaucipir) PET. Linear regressions estimated associations of Aß in a cortical composite and tau in the amygdala, entorhinal, and inferior temporal regions with STAI-Total and individual STAI item scores. Models adjusted for age, sex, education, marital status, depression, Apolipoprotein ε4 genotype, and subjective and objective cognition (Cognitive Function Index-participant; Preclinical Alzheimer Cognitive Composite). RESULTS: Greater Aß deposition was significantly associated with higher STAI-Worry, adjusting for all covariates, but not with other STAI items or STAI-Total scores. In mediation analyses, the association of Aß with STAI-Worry was partially mediated by subjective cognition with a stronger direct effect. No associations were found for regional tau deposition with STAI-Total or STAI-Worry score. CONCLUSION: Greater worry was associated with Aß but not tau deposition, independent of subjective and objective cognition in cognitively unimpaired (CU) older adults. These findings implicate worry as an early, specific behavioral marker and a possible therapeutic target in preclinical AD.

The effect of aging on facial emotion recognition in bipolar disorder.

OBJECTIVE: Convergent data point to an exaggerated negativity bias in bipolar disorder (BD), and little is known about whether people with BD experience the 'positivity effect' with increasing age. METHOD: This is a cross sectional study of 202 participants with BD aged 18-65, and a sample (n = 53) of healthy controls (HCs). Participants completed the CANTAB Emotion Recognition Task (ERT). Using analysis of variance, we tested for a main effect of age, diagnosis, and an interaction of age x diagnosis on both negative and positive conditions. RESULTS: We observed increased accuracy in identifying positive stimuli in the HC sample as a function of increasing age, a pattern that was not seen in participants with BD. Specifically, there was a significant diagnosis by age cohort interaction on ERT performance that was specific to the identification of happiness, where the Later Adulthood cohort of HCs was more accurate when identifying happy faces relative to the same cohort of BD patients. CONCLUSION: Later life looks different for people with BD. With an aging population globally, gaining a clearer picture of the effects of recurrent mood dysregulation on the brain will be critical in guiding efforts to effectively optimize outcomes in older adults with BD.