Examining the association between genetic liability for schizophrenia and psychotic symptoms in Alzheimer's disease
Creese, Byron; Vassos, Evangelos; Bergh, Sverre; Athanasiu, Lavinia; Johar, Iskandar; Rongve, Arvid; Medbøen, Ingrid Tøndel; Da Silva, Miguel Vasconcelos; Aakhus, Eivind; Andersen, Fred; Bettella, Francesco; Brækhus, Anne; Djurovic, Srdjan; Paroni, Giulia; Proitsi, Petroula; Saltvedt, Ingvild; Seripa, Davide; Stordal, Eystein; Fladby, Tormod; Aarsland, Dag; Andreassen, Ole Andreas; Ballard, Clive; Selbæk, Geir
Peer reviewed, Journal article
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Psychosis (delusions or hallucinations) in Alzheimer’s disease (AD + P) occurs in up to 50% of individuals and is associated with significantly worse clinical outcomes. Atypical antipsychotics, first developed for schizophrenia, are commonly used in AD + P, suggesting shared mechanisms. Despite this implication, little empirical research has been conducted to examine whether there are mechanistic similarities between AD + P and schizophrenia. In this study, we tested whether polygenic risk score (PRS) for schizophrenia was associated with AD + P. Schizophrenia PRS was calculated using Psychiatric Genomics Consortium data at ten GWAS p value thresholds (PT) in 3111 AD cases from 11 cohort studies characterized for psychosis using validated, standardized tools. Association between PRS and AD + P status was tested by logistic regression in each cohort individually and the results meta-analyzed. The schizophrenia PRS was associated with AD + P at an optimum PT of 0.01. The strongest association was for delusions where a one standard deviation increase in PRS was associated with a 1.18-fold increased risk (95% CI: 1.06–1.3; p = 0.001). These new findings point towards psychosis in AD—and particularly delusions—sharing some genetic liability with schizophrenia and support a transdiagnostic view of psychotic symptoms across the lifespan.