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RSNA: Anxiety May Hasten Progression to Alzheimer Disease

Rate of progression from MCI to AD increased with ApoE4, anxiety, lower hippocampal and entorhinal cortex volumes

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WEDNESDAY, Nov. 25, 2020 (HealthDay News) -- Apolipoprotein E4 (ApoE4) genotype, anxiety, and lower hippocampal (HV) and entorhinal cortex volumes (ERV) are associated with an elevated progression rate from mild cognitive impairment (MCI) to Alzheimer disease (AD), according to a study scheduled for presentation at the annual meeting of the Radiological Society of North America, held virtually from Nov. 29 to Dec. 5.

Jenny L. Uber, from the Medical University of South Carolina in Charleston, and colleagues examined the effect of anxiety and depression on progression of MCI to AD in a population of 339 patients (mean age, 72 years) with a baseline diagnosis of MCI. Of these patients, 72 and 267 progressed to AD and remained stable, respectively.

The researchers found that among MCI patients with and without progression to AD, there was no difference in age, gender, or years of education. Significantly lower normalized HV and ERV, greater frequency of the ApoE4 allele, and greater maximum levels of anxiety and depression were seen for patients who progressed to AD. An increased rate of progression from MCI to AD was seen in association with the presence of ApoE4, a higher level of anxiety, and lower HV and ERV.

"We need to better understand the association between anxiety disorders and cognitive decline," a coauthor said in a statement. "If we were able in the future to find that anxiety is actually causing progression, then we should more aggressively screen for anxiety disorders in the elderly."

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