Lecture – Investigations of Emotional and Social Function in Preclinical Alzheimer’s Disease

Available with English captions.

Presented by Nancy J. Donovan, MD, Brigham and Women’s Hospital – Visiting Scholar Series lecture

Alzheimer’s disease (AD) begins with a long preclinical stage defined by the abnormal accumulation of amyloid-beta and tau proteins. Using neuroimaging, these pathological proteins, or “biomarkers,” can be measured.

Watch now to learn more about:

  • Alzheimer’s disease as a biologic process that encompasses preclinical, mild cognitive impairment (minor neurocognitive disorder), and dementia (major neurocognitive disorder) stages
  • Recent studies into emotional and social functions related to AD
  • How psychiatric symptoms, such as depression, anxiety, and loneliness, have been associated with higher levels of brain amyloid deposition in cognitively unimpaired older adults

Studies show that transitional cognitive and neurobehavioral changes may occur during the AD pathophysiologic process prior to cognitive impairment. Identifying these transitional changes in older adults with biological markers of AD may define those at greatest risk of progression.

In this talk, Donovan describes recent research investigating emotional and social function in individuals with preclinical AD. These studies, she reports, show that approximately 25% of cognitively normal older adults have elevated levels of brain amyloid-beta that places them at higher risk of progression to cognitive impairment. Many of these individuals also have symptoms such as depression, anxiety, and loneliness.

Much of the lecture focuses on findings from the Harvard Aging Brain Study. This long-running study investigates changes in molecular, functional, and structural imaging markers that signal a transition from normal cognition to cognitive decline, leading to preclinical AD.

As part of the study, Donovan and her team observed 270 cognitively normal older adults who had a history of remitted mild depression and anxiety. The researchers sought to find out whether the changes that a doctor sometimes sees on a brain scan are related to early memory changes that occur in older healthy adults.

Based on the study, Donovan and her colleagues found that it may be possible that age-related pathological changes in certain regions of the brain may contribute to deficiencies in the way people process social interactions.

Donovan asserts that incremental declines in objective cognition, subjective changes in cognition, and neurobehavioral changes related to social function and anxiety could be “transitional” changes. These changes could serve as early markers of underlying AD pathology in unimpaired older adults.

Defining the earliest detectable changes in AD may advance the development and implementation of secondary prevention treatments, she says.