BU study: Patients with AD have higher frequency of mental health symptoms which can precede memory problems

FOR IMMEDIATE RELEASE, July 17, 2024
Contact: Gina DiGravio, 617-358-7838, ginad@bu.edu

BU Study: Patients with AD have Higher Frequency of Mental Health Symptoms which can Precede Memory Problems

Findings also suggest that mental health symptoms in persons in early stages of AD could be an important target for treatment

(Boston)—Decline in memory and other thinking abilities is the most well-known result of Alzheimer's disease (AD). However, many individuals with this condition also experience mental health symptoms such as agitation, depression, apathy, and trouble with sleep.

A new study from researchers at Boston University Chobanian & Avedisian School of Medicine has found that the pathology behind AD may be a direct reason for emotional and behavioral symptoms. Additionally, they discovered when individuals with AD experience decline in memory and thinking abilities, their mental health tends to be worse. 

“Mental health symptoms in persons with AD are a serious concern, as they can have a significant impact on the patient and their families quality of life. Importantly, these symptoms might emerge before thinking and memory problems begin and we need to better understand what causes these earlier symptoms so that we can better manage them,” said corresponding author Michael Alosco, PhD, associate professor of neurology. 

The researchers investigated participants from the National Alzheimer’s Coordinating Center, a large national database that is publicly available to facilitate research on AD and similar types of dementias. These persons had samples of cerebrospinal fluid (CSF) analyzed for markers of AD, as well as memory testing, evaluation of dementia severity, and a rating of their mental health symptoms by their caregiver or family member. Statistical analysis was then performed on this data.

The researchers found that greater levels of proteins associated with AD, as indicated by CSF markers, predicted various mental health symptoms, which was only partially explained by cognitive symptoms. That is, the mental health symptoms were not fully explained by response to memory difficulties but may be a direct result of underlying brain changes related to AD. Furthermore, greater mental health symptoms and memory difficulties resulted in greater difficulties with daily function. However, some of these connections were only true when individuals with dementia were included. “This suggests that when individuals are in earlier stages of AD, mental health symptoms may come from a variety of life factors, but when the disease progresses, AD itself is more likely to be the cause,” explained first author Brandon Frank, PhD, assistant professor of neurology at the school.

According to the researchers, persons diagnosed with AD may still suffer from mental health problems due to other causes. “As a result, a holistic approach to treatment is important. Treatments such as cognitive rehabilitation may help loved ones work around their memory difficulties but may also help them feel better,” added Frank.

These findings appear online in the Journal of Alzheimer’s Disease.

This work was supported by grants from the National Institutes of Health (P30AG072978) and the Department of Veterans’ Affairs (I01BX005933). This publication was also supported through BU CTSI Grant Number 1UL1TR001430. HZ is a Wallenberg Scholar and a Distinguished Professor at  the Swedish Research Council supported by grants from the Swedish Research Council (#2023-00356; #2022-01018 and #2019-02397), the European Union’s Horizon Europe research and innovation programme under grant agreement No 101053962, Swedish State Support for Clinical Research  (#ALFGBG-71320), the Alzheimer Drug Discovery Foundation (ADDF), USA (#201809-2016862), the AD Strategic Fund and the Alzheimer’s Association (#ADSF-21-831376-C, #ADSF-21-831381-C, #ADSF-21-831377-C, and #ADSF-24-1284328-C), the Bluefield Project, Cure Alzheimer’s Fund, the Olav Thon Foundation, the Erling-Persson Family Foundation, Familjen Ronstroms Stiftelse, Stiftelsen for Gamla Tj ¨ anarinnor, Hj arnfonden, Sweden (#FO2022-0270), the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 860197 (MIRIADE), the European Union Joint Programme – Neurodegenerative Disease Research (JPND2021-00694), the National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre, and the UK Dementia Research Institute at UCL (UKDRI1003). KB is supported by the Swedish Research Council (#2017-00915), the Alzheimer Drug Discovery Foundation (ADDF), USA (#RDAPB-201809-2016615), the Swedish Alzheimer Foundation (#AF742881), Hjarnfonden, Sweden (#FO2017-0243), the Swedish state under the agreement between the Swedish government and the County Councils, the ALF-agreement (#ALFGBG-715986), the European Union Joint Program for Neurodegenerative Disorders (JPND2019-466-236), and the National Institute of Health (NIH), USA, (grant #1R01AG068398-01). TKK was funded by the Brightfocus Foundation (#A2020812F), the Swedish Alzheimer  Foundation (Alzheimerfonden; #AF-930627), the Swedish Brain Foundation (Hjarnfonden; #FO2020- 930 0240), the Swedish Parkinson Foundation (Parkinsonfonden), the Swedish Dementia Foundation (Demensforbundet), the Agneta Prytz-Folkes & Gosta Folkes Foundation (#2020-00124), the Aina (Ann) Wallstroms and Mary-Ann Sjobloms Foundation, the Anna Lisa and Brother Bjornsson’s Foundation, Gamla Tjanarinnor, and the Gun and Bertil Stohnes Foundation. KWT is supported by the US Department of Veterans Affairs, (# IK2 CX002065). JCM is funded by grants from the National Institutes of Health (P30 AG066444; P01AG003991; 941 P01AG026276). GMB is supported by the National Institute on Aging (R01AG080469, R01AG068183, 943 R01AG067428, R01AG074302, R01AG074302) and Bright Focus Foundation (A2021142 S).

Note to Editor:

Drs. Henrik Zetterberg and Ganesh Babulal are Editorial Board Members of this journal but were not involved in the peer-review process of this article nor had access to any information regarding its peer-review. MLA receives research support from Life Molecular Imaging Inc and Rainwater Charitable Foundation Inc. He has also received a single time honorarium from the Michael J Fox Foundation for services unrelated to this study. He received royalties from Oxford University Press Inc. SES served on advisory boards for Eisai. AEB receives research support from Bristol-Myers Squibb and Vox Neuro. He receives consulting monies from Eli Lilly and AbbVie. He receives royalties from Elsevier and Oxford University Press. HZ has served at scientific advisory boards and/or as a consultant for Abbvie, Acumen, Alector, Alzinova, ALZPath, Amylyx, Annexon, Apellis, Artery Therapeutics, AZTherapies, Cognito Therapeutics, CogRx, Denali, Eisai, Merry Life, Nervgen, Novo Nordisk, Optoceutics, Passage Bio, Pinteon Therapeutics, Prothena, Red Abbey Labs, reMYND, Roche, Samumed, Siemens Healthineers, Triplet Therapeutics, and Wave, has given lectures in symposia sponsored by Alzecure, Biogen, Cellectricon, Fujirebio, Lilly, Novo Nordisk, and Roche, and is a co-founder of Brain Biomarker Solutions in Gothenburg AB (BBS), which is a part of the GU Ventures Incubator Program (outside submitted work). None of this research, consulting, or royalties are related to this study.