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Clinical Manifestations.

Yiqi Zhu1, Jean-Francois Trani2,3, Ramkrishna Singh4

  • 1Washington University School of Medicine, Saint Louis, MO, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Major depressive disorder (MDD) is linked to increased mild behavioral impairment (MBI) symptoms, even without Alzheimer's disease biomarkers. Early MDD detection and treatment may help manage neuropsychiatric symptoms.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Psychiatry

Background:

  • Neuropsychiatric symptoms (NPS) and biomarkers are early indicators for Alzheimer's disease and related dementias (ADRD).
  • Major depressive disorder (MDD) shares NPS with ADRD, complicating differential diagnosis.
  • Plasma biomarkers and mild behavioral impairment (MBI) are independently associated with ADRD risk, but their interrelationship in MDD requires further study.

Purpose of the Study:

  • To explore the cross-sectional associations between plasma biomarkers and MBI in individuals with and without MDD.

Main Methods:

  • 334 cognitively normal older adults (CDR=0) were assessed for NPS using the MBI checklist.
  • Plasma biomarkers (Aβ42/Aβ40, ptau181/nptau181, ptau217/nptau217) were measured.
  • Logistic regression models evaluated associations between MDD, plasma biomarkers, and MBI, controlling for covariates.

Main Results:

  • MDD diagnosis was associated with increased likelihood of MBI symptoms, regardless of Aβ42/Aβ40 biomarker status.
  • Participants with MDD and negative Aβ42/Aβ40 were 5.42 times more likely to report MBI symptoms.
  • Participants with both MDD and positive Aβ42/Aβ40 were 7.23 times more likely to report MBI symptoms.

Conclusions:

  • MDD is associated with worsening MBI, suggesting early MDD management may reduce NPS severity.
  • Differentiating ADRD from MDD remains challenging.
  • Further research is needed to clarify distinct diagnostic and behavioral characteristics of ADRD and MDD.