The course of apathy in late‐life depression treated with electroconvulsive therapy; a prospective cohort study

Carlier, Angela; Exel, Eric van; Dols, Annemiek; Bouckaert, Filip; Sienaert, Pascal; Kate, Mara ten; Wattjes, Mike P.; Vandenbulcke, Mathieu; Stek, Max L.; Rhebergen, Didi

doi:10.1002/gps.4917

Cited by 7 publications

(3 citation statements)

References 46 publications

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“…However, this specific group referred for and treated with ECT also indicates a strength of this study design, as all patients were severely ill. Moreover, we found that after ECT apathy symptoms may perpetuate in individual patients that were less responsive but this was not associated with WMH 35 . Thirdly, the risk of inadequate findings due to multiple testing.…”

Section: Strengths and Limitationsmentioning

confidence: 65%

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Are Apathy and Depressive Symptoms Related to Vascular White Matter Hyperintensities in Severe Late Life Depression?

Oudega

Siddiqui

Wattjes

et al. 2020

J Geriatr Psychiatry Neurol

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Objective: Apathy symptoms are defined as a lack of interest and motivation. Patients with late-life depression (LLD) also suffer from lack of interest and motivation and previous studies have linked apathy to vascular white matter hyperintensities (WMH) of the brain in depressed and nondepressed patients. The aim of this study was to investigate the relationship between apathy symptoms, depressive symptoms, and WMH in LLD. We hypothesize that late-onset depression (LOD; first episode of depression after 55 years of age) is associated with WMH and apathy symptoms. Methods: Apathy scores were collected for 87 inpatients diagnosed with LLD. Eighty patients underwent brain magnetic resonance imaging. Associations between depressive and apathy symptoms and WMH were analyzed using linear regression. Results: All 3 subdomains of the 10-item Montgomery–Åsberg Depression Rating Scale correlated significantly with the apathy scale score (all P < .05). In the total sample, apathy nor depressive symptoms were related to specific WMH. In LOD only, periventricular WMH were associated with depression severity (β = 5.21, P = .04), while WMH in the left infratentorial region were associated with apathy symptoms (β coefficient = 5.89, P = .03). Conclusion: Apathy and depressive symptoms are highly overlapping in the current cohort of older patients with severe LLD, leading to the hypothesis that apathy symptoms are part of depressive symptoms in the symptom profile of older patients with severe LLD. Neither apathy nor depressive symptoms were related to WMH, suggesting that radiological markers of cerebrovascular disease, such as WMH, may not be useful in predicting these symptoms in severe LLD.

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Section: Strengths and Limitationsmentioning

confidence: 65%

“…Moreover, we found that after ECT apathy symptoms may perpetuate in individual patients who were less responsive but this was not associated with WMH. 36 Fourth, is the risk of inadequate findings due to multiple testing. We addressed this point with correction for multiple testing, according to the Benjamini–Hochberg procedure.…”

Section: Discussionmentioning

confidence: 99%

Are Apathy and Depressive Symptoms Related to Vascular White Matter Hyperintensities in Severe Late Life Depression?

Oudega

Siddiqui

Wattjes

et al. 2020

J Geriatr Psychiatry Neurol

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“…A pathy is defined as a lack of motivation and loss of interest in almost all daily activities and other persons, and is associated with a high caregiver burden. 1 Apathy can occur as part of a depressive disorder 2 and is particularly prevalent in patients with neurodegenerative diseases; however, apathy also frequently occurs in the older general population. 3 Both cerebrovascular and cardiovascular diseases are risk factors for apathy.…”

mentioning

confidence: 99%

Lower Blood Pressure, Small‐Vessel Disease, and Apathy in Older Persons With Mild Cognitive Deficits

Bertens

Foster-Dingley

Moonen

et al. 2020

J American Geriatrics Society

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BACKGROUND In older persons, both high and low blood pressure (BP) levels are associated with symptoms of apathy. Population characteristics, such as burden of cerebral small‐vessel disease (CSVD), may underlie these apparently contradictory findings. We aimed to explore, in older persons, whether the burden of CSVD affects the association between BP and apathy. DESIGN Cross‐sectional study. SETTING Primary care setting, the Netherlands. PARTICIPANTS Community‐dwelling older persons (mean age = 80.7 years; SD = 4.1 years) with mild cognitive deficits and using antihypertensive treatment, participating in the baseline measurement of the magnetic resonance imaging substudy (n = 210) of the Discontinuation of Antihypertensive Treatment in the Elderly Study Leiden. MEASUREMENTS During home visits, BP was measured in a standardized way and apathy was assessed with the Apathy Scale (range = 0‐42). Stratified linear regression analyses were performed according to the burden of CSVD. A higher burden of CSVD was defined as 2 or more points on a compound CSVD score (range = 0‐3 points), defined as presence of white matter hyperintensities (greater than median), any lacunar infarct, and/or two or more microbleeds. RESULTS In the entire population, those with a lower systolic and those with a lower diastolic BP had more symptoms of apathy (β = −.35 [ P = .01] and β = −.66 [ P = .02], respectively). In older persons with a higher burden of CSVD (n = 50 [24%]), both lower systolic BP (β = −.64, P = .02) and lower diastolic BP (β = −1.6, P = .01) were associated with more symptoms of apathy, whereas no significant association was found between BP and symptoms of apathy in older persons with a lower burden of CSVD (n = 160). CONCLUSIONS Particularly in older persons with a higher burden of CSVD, lower BP was associated with more symptoms of apathy. Adequate BP levels for optimal psychological functioning may vary across older populations with a different burden of CSVD. J Am Geriatr Soc 68:1811‐1817, 2020.

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Impact of vascular risk factors on clinical outcome in elderly patients with depression receiving electroconvulsive therapy

Jurek¹,

Dorey²,

Nourredine³

et al. 2021

Journal of Affective Disorders

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The course of apathy in late‐life depression treated with electroconvulsive therapy; a prospective cohort study

Cited by 7 publications

References 46 publications

Are Apathy and Depressive Symptoms Related to Vascular White Matter Hyperintensities in Severe Late Life Depression?

Are Apathy and Depressive Symptoms Related to Vascular White Matter Hyperintensities in Severe Late Life Depression?

Lower Blood Pressure, Small‐Vessel Disease, and Apathy in Older Persons With Mild Cognitive Deficits

Impact of vascular risk factors on clinical outcome in elderly patients with depression receiving electroconvulsive therapy

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