Though most people with Alzheimer’s disease aren’t diagnosed until after age 65, the disease can begin in their brains years or even decades before that. For this reason, scientists have been trying to identifying biomarkers that will allow us to diagnose Alzheimer’s at an earlier stage, prior to the onset of cognitive symptoms.

In a study published last week in The American Journal of Psychiatry, researchers from Harvard University examined 270 subjects aged 62 to 90, all of whom lived in a retirement community and initially showed no signs of cognitive impairment or mental illness. The subjects were given a test for geriatric depression and a PET scan of their brains annually for five years.

At the beginning of the study, participants who had depression had higher levels of amyloid-beta, a toxic protein linked to Alzheimer’s disease, in their brains. Furthermore, participants with higher amyloid-beta levels at baseline had steeper increases in their geriatric depression scores after five years. These results suggest that a sudden development or worsening of depressive symptoms could be a sign of early Alzheimer’s disease.

Next, the researchers looked at the participants’ subscores for different sections of the depression test. They found that only the anxiety subscore was correlated with amyloid-beta levels. The other two subscores, which relate to apathy and unhappiness, had no relationship to amyloid-beta. This suggests that anxious-depressive symptoms are the strongest predictor of early Alzheimer’s disease.

It’s difficult to determine from this study whether anxiety or depression could lead to Alzheimer’s disease, or if instead preclinical Alzheimer’s causes anxiety/depression. It’s likely that there are many other factors at play, such as social interaction, diet, and exercise levels. Additionally, the small sample size prevents us from drawing broad conclusions. However, the authors of the study are currently working on a follow-up analysis of these subjects, which should illuminate whether the people with higher amyloid-beta levels went on to be diagnosed with Alzheimer’s disease.

In the meantime, if you or a loved one notices a sudden increase in anxious-depressive symptoms, this should be taken seriously and brought up with a doctor. An earlier Alzheimer’s disease diagnosis, prior to the development of dementia, may allow our drugs to act more effectively and slow the rate of cognitive decline.

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