Neuropsychological correlates of apathy in mild cognitive impairment and Alzheimer's disease: the role of executive functioning

Drijgers, Rosa L.; Verhey, Frans R.J.; Leentjens, Albert F.G.; Köhler, Sebastian; Aalten, Pauline

doi:10.1017/s1041610211001037

Cited by 56 publications

(49 citation statements)

References 33 publications

(52 reference statements)

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“…These results suggested that, independently from clinical diagnosis, apathetic patients showed relevant executive impairments, in line with most previous studies [14,15,20,21,23,25,26]. In other terms, the present data indicated a strong association between apathy and alterations of cognitive functions mediated by prefrontal cortex, since apathetic and non-apathetic patients were matched for age, educational level and severity of general cognitive decline.…”

Section: Discussionsupporting

confidence: 92%

“…Apathy has also been observed in Alzheimer's disease (AD) since its early stages [24], and is associated with low functional autonomy, severe executive dysfunction and fast cognitive and functional decline [24][25][26][27]. Brain imaging studies in AD reported a significant association between apathy and abnormal perfusion in the frontal cortex and in the cingulate area [28][29][30][31][32][33][34][35].…”

Section: Introductionmentioning

confidence: 99%

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Apathy and Related Executive Syndromes in Dementia Associated with Parkinson’s Disease and in Alzheimer’s Disease

Grossi

Santangelo

Barbarulo

et al. 2013

Behavioural Neurology

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Abstract. Apathy is defined as a lack of motivation and has been reported to be common in Alzheimer's disease (AD) and Parkinson's disease (PD). To explore the neuropsychological correlates of apathy in patients with PD related dementia (PDD) and AD and to identify the specific cognitive profile of apathy in the two forms of neurodegenerative disease, 61 non-depressed patients (29 PDD and 32 AD) were selected. Out of these, 29 patients (47.5%) were detected as apathetic (14 PDD-A+ and 15 AD-A+), and 32 patients as non-apathetic (15 PDD-A-and 17 AD-A-). All patients underwent cognitive tasks tapping memory, visuospatial and executive functions, behavioral rating scales and Clinical Judgment for Apathy Syndrome (CJ-AS), an inventory developed to measure severity of apathy. The four subgroups differed significantly on memory and frontal tasks. The PDD-A+ performed significantly worse than PDD-Aon frontal tasks. The AD-A+ had poorer performance than AD-A-on frontal tasks. Last, PDD-A+ achieved significantly higher scores than AD-A+ on memory tasks. The four groups differed significantly on CJ-AS and behavioral rating scales. The results showed that apathetic patients with both forms of dementia showed a common neuropsychological and behavioral picture, characterized by defects on frontal tasks, thus strongly supporting the existence of an 'apathetic syndrome', characterized by specific cognitive and psychological symptoms.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Apathy and Related Executive Syndromes in Dementia Associated with Parkinson’s Disease and in Alzheimer’s Disease

Grossi

Santangelo

Barbarulo

et al. 2013

Behavioural Neurology

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“…Investigators have also suggested that apathy may contribute to cognitive impairment more significantly than does depression in AD [3,7,16]. Specifically, Kuzis et al [16] found that apathy was associated with significantly worse performance on measures of verbal memory, confrontation naming, nonverbal reasoning, and verbal fluency.…”

Section: The Impact Of Depression and Apathy On Cognition In Admentioning

confidence: 99%

Factor Structure of the Geriatric Depression Scale and Relationships with Cognition and Function in Alzheimer’s Disease

Havins

Massman

Doody

2012

Dement Geriatr Cogn Disord

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Background/Aims: No study to date has systematically explored whether the Geriatric Depression Scale (GDS) measures symptoms of apathy and dysphoria in patients with Alzheimer’s disease (AD) or related these constructs to cognitive and functional status. Methods: Exploratory factor analysis (EFA) was used to identify factors of the GDS in a sample of 569 patients with probable AD. Two-way ANOVAs were used to determine the relationship of apathy and dysphoria to neuropsychological and functional measures. Results: The EFA yielded four factors associated with apathy, dysphoria, social withdrawal and cognitive impairment. Apathy was associated with greater impairments in verbal memory, motor speed, and functional abilities. Conclusion: Apathy, but not dysphoria, was associated with some cognitive and functional variables. Results suggest that the GDS may be used as a screening measure for symptoms of apathy in AD.

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“…Indeed, different executive processes contribute to successfully manage adaptation to the environment: abilities to make decisions, initiate tasks, generate adaptation strategies and judge their accuracy, self-correct and complete tasks effectively. Impairment of these executive processes was shown to be related to apathy which is an early symptom in AD [13].…”

Section: Introductionmentioning

confidence: 99%

DAD-6: A 6-ltem Version of the Disability Assessment for Dementia Scale Which May Differentiate Alzheimer’s Disease and Mild Cognitive Impairment from Controls

Rotrou

Hugonot‐Diener

et al. 2012

Dement Geriatr Cogn Disord

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Background: The need to detect early changes in instrumental activities of daily life led us to modify the Disability Assessment for Dementia Scale (DAD) by focusing on executive components of 6 instrumental items (DAD-6). Aim: To evaluate the relevance of the DAD-6 for detecting early impairment in a nondemented population. Methods: The DAD-6 was administered to informants of 84 patients: 31 with mild dementia (MD), 53 with mild cognitive impairment (MCI) and 55 healthy controls. Results: DAD-6 scores gradually decreased with increasing severity of the cognitive status [18 in healthy controls vs. 15.1 ± 3.2 in MCI versus 9.6 ± 3.5 in MD, p < 0.0001). Receiver-operating characteristic curve analyses yielded an optimal cut score of 14 to distinguish MCI from MD with a sensitivity of 0.83 (95% confidence interval 0.74–0.92) and a specificity of 0.84 (0.71–0.94), and a cut score of 15 to distinguish single-domain MCI from multi-domain MCI with a sensitivity of 0.96 (0.90–0.99) and a specificity of 0.54 (0.33–0.75). Conclusion: The DAD-6 reliably detects early loss of autonomy due to cognitive impairment.

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Neuropsychological correlates of apathy in mild cognitive impairment and Alzheimer's disease: the role of executive functioning

Cited by 56 publications

References 33 publications

Apathy and Related Executive Syndromes in Dementia Associated with Parkinson’s Disease and in Alzheimer’s Disease

Apathy and Related Executive Syndromes in Dementia Associated with Parkinson’s Disease and in Alzheimer’s Disease

Factor Structure of the Geriatric Depression Scale and Relationships with Cognition and Function in Alzheimer’s Disease

DAD-6: A 6-ltem Version of the Disability Assessment for Dementia Scale Which May Differentiate Alzheimer’s Disease and Mild Cognitive Impairment from Controls

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