Associations between Psychosocial Factors and Apolipoprotein E in the Development of Alzheimer’s Disease Dementia

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Citation

Burke, Shanna, “Associations between Psychosocial Factors and Apolipoprotein E in the Development of Alzheimer’s Disease Dementia,” Scholar@Simmons, accessed April 4, 2020, https://beatleyweb.simmons.edu/scholar/items/show/333.

Title

Associations between Psychosocial Factors and Apolipoprotein E in the Development of Alzheimer’s Disease Dementia

Creator

Burke, Shanna

Date

2015

Description

Alzheimer’s disease dementia (AD) arises from neurodegeneration in the brain, causing cognitive decline and memory loss. Neuropsychiatric symptoms, including depression and sleep disturbance are considered early signs of AD, but may also contribute to risk of AD due to dementia. Apolipoprotein (APOE) Ɛ4 is a susceptibility gene linked to AD dementia. The three studies, which comprise this dissertation, examined whether various neuropsychiatric symptoms and APOE genotype increase the hazard of AD. Further, antidepressant medications were hypothesized to decrease hazard of AD development among Ɛ4 carriers and for participants reporting recent depression symptoms or lifetime depression.

Utilizing data from the National Alzheimer’s Coordinating Center Uniform Data Set, a sample of participants free from AD dementia symptoms at visit one was examined over the course of two or more visits. Survival analysis was used to explore the relationships between psychosocial variables, medications and APOE in participants between 2005 and 2014. Cox proportional hazard models were utilized to explore the main effects and synergistic interactions, using the theory of gene-environmental correlation as a guiding conceptual framework.

Findings suggest that sleep disturbance, depression, and APOE genotype are associated with AD among a group of initially asymptomatic participants. The hazard of developing AD dementia was nine times higher for those with depression and the Ɛ4 homozygote, and eight times that of the reference group among those with two Ɛ4 alleles and sleep disturbance. The hazard of developing AD was thirteen times higher for Ɛ4 carriers with delusions and eleven times greater for those reporting apathy or disinhibition. Statistically significant hazards (p >.001) occurred for Ɛ4 carriers reporting a single symptom on the Neuropsychiatric Inventory Questionnaire. In most cases, among antidepressant medication users, the relationship between depression and AD was no longer statistically significant. One of the eight generic medication analyzed demonstrated protective benefits. These studies highlight the need for practitioners to treat neuropsychiatric symptoms as potentially modifiable risk factors, especially among those further at risk due to apolipoprotein E.

Publisher

Simmons College (Boston, Mass.)

Format

1 PDF (86 Pages)

Language

English

Type

Doctoral Dissertations

Collection