Leisure-Time Physical Inactivity Associated with Vascular Depression or Apathy in Community-Dwelling Elderly Subjects: The Sefuri Study

Yao, Hiroshi; Takashima, Yuki; Araki, Yuko; Uchino, Akira; Yuzuriha, Takefumi; Hashimoto, Manabu

doi:10.1016/j.jstrokecerebrovasdis.2015.07.018

Cited by 24 publications

(28 citation statements)

References 36 publications

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“…This result is in line with previous studies (Okura et al 2010) that have shown that apathy could be strongly associated with functional limitations in older adults with no dementia. This finding also highlights a bidirectional direction between apathy and functional impairment (i.e., physical functioning) as it has been shown that apathy can have a significant negative effect on physical functioning (Tang et al 2013;Yao et al 2015). Overall, our results suggest that some variables such as physical or cognitive functioning could be both consequences and causes of apathy, leading to the maintenance of vicious circles.…”

Section: Discussionsupporting

confidence: 75%

“…The estimation of the prevalence of cerebrovascular diseases was based only on self-report and may have underestimated the prevalence of cardiovascular diseases. For example, lower blood pressure (Moonen et al 2015) or cardiovascular disease and cardiovascular risk factors (Ligthart et al 2012) have also been shown to be involved in increased apathy in normal aging, even if cardiovascular risk factors per se are more indirectly correlated with apathy than silent cerebrovascular disease (Yao et al 2015). Similarly, pharmacological treatments were not assessed despite the evidence that some agents such as antidepressants (Barnhart et al 2004;Fava et al 2006) can induce apathy syndrome.…”

Section: Limitationsmentioning

confidence: 99%

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Multidimensional model of apathy in older adults using partial least squares—path modeling

Raffard¹,

Bortolon²,

Burca³

et al. 2016

AGE

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Apathy defined as a mental state characterized by a lack of goal-directed behavior is prevalent and associated with poor functioning in older adults. The main objective of this study was to identify factors contributing to the distinct dimensions of apathy (cognitive, emotional, and behavioral) in older adults without dementia. One hundred and fifty participants (mean age, 80.42) completed self-rated questionnaires assessing apathy, emotional distress, anticipatory pleasure, motivational systems, physical functioning, quality of life, and cognitive functioning. Data were analyzed using partial least squares variance-based structural equation modeling in order to examine factors contributing to the three different dimensions of apathy in our sample. Overall, the different facets of apathy were associated with cognitive functioning, anticipatory pleasure, sensitivity to reward, and physical functioning, but the contribution of these different factors to the three dimensions of apathy differed significantly. More specifically, the impact of anticipatory pleasure and physical functioning was stronger for the cognitive than for emotional apathy. Conversely, the impact of sensibility to reward, although small, was slightly stronger on emotional apathy. Regarding behavioral apathy, again we found similar latent variables except for the cognitive functioning whose impact was not statistically significant. Our results highlight the need to take into account various mechanisms involved in the different facets of apathy in older adults without dementia, including not only cognitive factors but also motivational variables and aspects related to physical disability. Clinical implications are discussed.

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Section: Discussionsupporting

confidence: 75%

Section: Limitationsmentioning

confidence: 99%

Multidimensional model of apathy in older adults using partial least squares—path modeling

Raffard¹,

Bortolon²,

Burca³

et al. 2016

AGE

View full text Add to dashboard Cite

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“…The importance of deep WMHs and subcortical lacunar infarcts on the risk of depressive symptoms [107–109] and a strong relationship between depression and WMH volume [110] were emphasized. A recent study showed that diffuse WMHs are one of the major factors that cause apathy and have negative effects on quality of life [111], while others could not demonstrate any significant association between WMH progression and depression at baseline [112]. A multicenter longitudinal study showed that WMHs predated the development of depressive symptoms in later life.…”

Section: Resultsmentioning

confidence: 99%

Vascular depression consensus report – a critical update

Aizenstein

Baskys

Boldrini

et al. 2016

BMC Med

187

145

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BackgroundVascular depression is regarded as a subtype of late-life depression characterized by a distinct clinical presentation and an association with cerebrovascular damage. Although the term is commonly used in research settings, widely accepted diagnostic criteria are lacking and vascular depression is absent from formal psychiatric manuals such as the Diagnostic and Statistical Manual of Mental Disorders, 5th edition – a fact that limits its use in clinical settings. Magnetic resonance imaging (MRI) techniques, showing a variety of cerebrovascular lesions, including extensive white matter hyperintensities, subcortical microvascular lesions, lacunes, and microinfarcts, in patients with late life depression, led to the introduction of the term “MRI-defined vascular depression”.DiscussionThis diagnosis, based on clinical and MRI findings, suggests that vascular lesions lead to depression by disruption of frontal–subcortical–limbic networks involved in mood regulation. However, despite multiple MRI approaches to shed light on the spatiotemporal structural changes associated with late life depression, the causal relationship between brain changes, related lesions, and late life depression remains controversial. While postmortem studies of elderly persons who died from suicide revealed lacunes, small vessel, and Alzheimer-related pathologies, recent autopsy data challenged the role of these lesions in the pathogenesis of vascular depression. Current data propose that the vascular depression connotation should be reserved for depressed older patients with vascular pathology and evident cerebral involvement. Based on current knowledge, the correlations between intra vitam neuroimaging findings and their postmortem validity as well as the role of peripheral markers of vascular disease in late life depression are discussed.ConclusionThe multifold pathogenesis of vascular depression as a possible subtype of late life depression needs further elucidation. There is a need for correlative clinical, intra vitam structural and functional MRI as well as postmortem MRI and neuropathological studies in order to confirm the relationship between clinical symptomatology and changes in specific brain regions related to depression. To elucidate the causal relationship between regional vascular brain changes and vascular depression, animal models could be helpful. Current treatment options include a combination of vasoactive drugs and antidepressants, but the outcomes are still unsatisfying.

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“…van Almenkerk et al (38) found apathy to be independently related to being in bed for >12 h a day in chronic stroke patients. Yao et al (39) found that apathy has significant negative effects on leisure-time PA in community-dwelling elderly subjects. To our knowledge, there is no study that aimed to define the effect of apathy on the PA level in the subacute stage of stroke.…”

Section: Discussionmentioning

confidence: 99%

Physical Activity Level of Ambulatory Stroke Patients: Is it Related to Neuropsychological Factors?

Hüseyinsinoğlu

Aslan

Tarakçı

et al. 2017

Arch Neuropsychiatr

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Introduction: Physical inactivity is an important risk factor for stroke and stroke recurrence. There is insufficient knowledge about the physical activity (PA) level in stroke patients who are ambulatory in the subacute phase. Our aim was to compare the PA level between ambulatory stroke patients and a population of the same age and to investigate neuropsychological factors that could affect the PA level in the same stroke group.Methods: Eighty-five subacute stroke patients and 58 healthy subjects were included. Patients' demographic features, disease-related features, and comorbidities were recorded. The PA level was assessed by the International Physical Activity Questionnaire-Short Version and a pedometer (OMRON Walking style II). The Apathy Rating Scale was applied to determine the apathy level. Depression level was investigated by the Geriatric Depression Scale. The standardized Mini-mental State Examination was performed to assess the cognitive status.Results: The PA level was significantly higher in the healthy group than in the stroke group (p<0.001).Step count and walking distance were significantly higher in healthy group (p=0.001 and p=0.04, respectively). The PA level of men was significantly higher than that of women (p=0.03). Participants who were classified as level 4 had a lower PA level than those who were classified as level 5 according to the Functional Ambulation Category. There was no relationship between the PA level and the apathy, cognitive, and depression levels in the stroke patients (p>0.05). Conclusion:Subacute stroke patients have a lower PA level than healthy subjects. This is not related to neuropsychological factors. The reasons for minor deficits related to ambulation should be researched further while developing strategies for increasing the PA level of subacute stroke patients.Keywords: Stroke, apathy, depression, cognition, physical activity ABSTRACT 155level cannot be explained only by loss of motor function, psychological and cognitive factors have been proposed to analyze (13,14). In light of these findings, we aimed to compare the PA level between ambulatory stroke patients and a population of the same age and to investigate the demographic features and disease-related and neuropsychological factors that could affect the PA level in the same stroke group. We hypothesized that the PA level of ambulatory subacute stroke patients would be less than that of healthy subjects. We further hypothesized that the PA level would be affected by neuropsychological factors in the same population.

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Leisure-Time Physical Inactivity Associated with Vascular Depression or Apathy in Community-Dwelling Elderly Subjects: The Sefuri Study

Cited by 24 publications

References 36 publications

Multidimensional model of apathy in older adults using partial least squares—path modeling

Multidimensional model of apathy in older adults using partial least squares—path modeling

Vascular depression consensus report – a critical update

Physical Activity Level of Ambulatory Stroke Patients: Is it Related to Neuropsychological Factors?

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