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Psychosocial risk factors and Alzheimer's disease: the associative effect of depression,sleep disturbance,and anxiety
Authors:Shanna L. Burke  Tamara Cadet  Amary Alcide  Janice O'Driscoll  Peter Maramaldi
Affiliation:1. School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USAsburke@fiu.edu;3. Oral Health Policy and Epidemiology, Simmons College School of Social Work, Harvard School of Dental Medicine, Boston, MA, USA;4. School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA;5. Hartford Faculty Scholar &6. National Mentor, Simmons College School of Social Work, Boston, MA, USA;7. Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA;8. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Abstract:ABSTRACT

Objectives: Alzheimer's disease (AD) dementia is a neurodegenerative condition, which leads to impairments in memory. This study predicted that sleep disturbance, depression, and anxiety increase the hazard of AD, independently and as comorbid conditions.

Methods: Data from the National Alzheimer's Coordinating Center was used to analyze evaluations of 12,083 cognitively asymptomatic participants. Survival analysis was used to explore the longitudinal effect of depression, sleep disturbance, and anxiety as predictors of AD. The comorbid risk posed by depression in the last two years coupled with sleep disturbance, lifetime depression and sleep disturbance, clinician-verified depression and sleep disturbance, sleep disturbance and anxiety, depression in the last two years and anxiety, lifetime depression and anxiety, and clinician-verified depression and anxiety were also analyzed as predictors of AD through main effects and additive models.

Results: Main effects models demonstrated a strong hazard of AD development for those reporting depression, sleep disturbance, and anxiety as independent symptoms. The additive effect remained significant among comorbid presentations.

Conclusion: Findings suggest that sleep disturbance, depression, and anxiety are associated with AD development among cognitively asymptomatic participants. Decreasing the threat posed by psychological symptoms may be one avenue for possibly delaying onset of AD.
Keywords:Alzheimer's disease  dementia  anxiety  depression  sleep disturbance
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