# Association of Alzheimer's disease concerns with amyloid burden and lifestyle behaviors in cognitively unimpaired older adults

## TL;DR

This study finds that concerns about Alzheimer's disease are linked to higher amyloid levels and worse lifestyle behaviors in older adults without cognitive issues.

## Contribution

The study shows AD concerns correlate with amyloid burden and lifestyle factors, especially in APOE ε4 carriers.

## Key findings

- AD concerns were associated with higher amyloid burden in cognitively unimpaired older adults.
- AD concerns were linked to lower likelihood of meeting walking guidelines and higher depressive symptoms in APOE ε4 carriers.
- Associations between AD concerns and amyloid burden were stronger in APOE ε4 carriers compared to non-carriers.

## Abstract

The extent to which Alzheimer's disease (AD) concerns relate to pathological changes in cognitively unimpaired populations is unclear.

We analyzed screening data from the Anti‐Amyloid Treatment in Asymptomatic Alzheimer's (A4) study to determine if AD concerns are associated with amyloid burden in cognitively unimpaired older adults, and how they relate to lifestyle. AD concerns were measured using the six‐item Concerns about Alzheimer's Disease Questionnaire. Regression estimated the association of AD concerns with amyloid burden, adjusting for covariates.

Of 4460 individuals, AD concerns were elevated in women, people with a dementia family history, apolipoprotein E (APOE) ε4 carriers, and individuals who did not meet walking or sleep guidelines. AD concerns were associated with higher amyloid burden (β [95% CI] = 0.002 [0.001–0.003], p = 0.007), with stronger effects in APOE ε4 carriers.

AD concerns were associated with a core diagnostic AD biomarker. Assessing AD concerns could inform future recruitment strategies.

Clinical Registration Trial:: ClinicalTrials.gov: ID NCT02008357.

Alzheimer's disease (AD) concerns were associated with higher amyloid burden.AD concerns were associated with higher depressive symptoms in apolipoprotein E (APOE) ε4 carriers.Concerns were associated with a lower likelihood of meeting daily walking guidelines.Associations were stronger in APOE ε4 carriers compared to non‐carriers.

Alzheimer's disease (AD) concerns were associated with higher amyloid burden.

AD concerns were associated with higher depressive symptoms in apolipoprotein E (APOE) ε4 carriers.

Concerns were associated with a lower likelihood of meeting daily walking guidelines.

Associations were stronger in APOE ε4 carriers compared to non‐carriers.