Vascular disease and apathy in old age. The Leiden 85‐plus Study

Mast, Roos C. van der; Vinkers, David J.; Stek, Max L.; Bek, Marie; Westendorp, Rudi G.J.; Gussekloo, Jacobijn; Craen, Anton J. M. de

doi:10.1002/gps.1872

Cited by 88 publications

(172 citation statements)

References 40 publications

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“…[15]. In a factor analysis of the GDS-15, these 3 items loaded on the same factor [16]. We recently confirmed this factor analysis of the GDS-15 in a cohort of 3,534 elderly, in which we also confirmed the clinical applicability of the GDS-3-apathy [17].…”

Section: Apathy and Depression Assessmentsupporting

confidence: 71%

“…We recently confirmed this factor analysis of the GDS-15 in a cohort of 3,534 elderly, in which we also confirmed the clinical applicability of the GDS-3-apathy [17]. The test characteristics of this GDS-3-apathy have been shown to be good compared to the 14-item apathy scale of Starkstein, with a sensitivity of 69% and a specificity of 85% [16,18]. The remaining items reflect general depressive affect and life satisfaction, which we will refer to as symptoms of depressive affect [15].…”

Section: Apathy and Depression Assessmentsupporting

confidence: 66%

“…Although this is a limitation of our study, this instrument has been shown to have good discriminating characteristics compared to the apathy scale of Starkstein [16,18]. In addition, Robert et al [20] emphasise that 'lack of interest' is the apathy dimension most associated with progression to AD, and 2 of the 3 apathy items in the GDS represent this same dimension.…”

Section: Discussionmentioning

confidence: 99%

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Symptoms of Apathy Are Associated with Progression from Mild Cognitive Impairment to Alzheimers Disease in Non-Depressed Subjects

Richard

Schmand

Eikelenboom

et al. 2012

Dement Geriatr Cogn Disord

102

104

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Background: Apathy is a common symptom in various neuropsychiatric diseases including mild cognitive impairment (MCI) and dementia. Apathy may be associated with an increased risk of cognitive decline. The objective of this study was to investigate if apathy predicts the progression from MCI to Alzheimer’s disease (AD). Methods: The Alzheimer’s Disease Neuroimaging Initiative is a prospective multicentre cohort study. At baseline, 397 patients with MCI without major depression were included. Clinical data and the Geriatric Depression Scale at baseline were used. Apathy was defined based on the 3 apathy items of the 15-item Geriatric Depression Scale. The main outcome measure was the association of apathy with progression from MCI to AD. Results: During an average follow-up of 2.7 years (SD 1.0), 166 (41.8%) patients progressed to AD. The presence of symptoms of apathy without symptoms of depressive affect increased the risk of progression from MCI to AD (hazard ratio = 1.85, 95% CI = 1.09–3.15). Apathy in the context of symptoms of depressive affect or symptoms of depressive affect alone, without apathy, did not increase the risk of progression to AD. Conclusions: Symptoms of apathy, but not symptoms of depressive affect, increase the risk of progression from MCI to AD. Apathy in the context of symptoms of depressive affect does not increase this risk. Symptoms of apathy and depression have differential effects on cognitive decline.

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Section: Apathy and Depression Assessmentsupporting

confidence: 71%

Section: Apathy and Depression Assessmentsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

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Symptoms of Apathy Are Associated with Progression from Mild Cognitive Impairment to Alzheimers Disease in Non-Depressed Subjects

Richard

Schmand

Eikelenboom

et al. 2012

Dement Geriatr Cogn Disord

102

104

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“…It has been reported that up to a quarter of nondemented community-dwelling elderly individuals have apathy (most without concomitant depression) [50,51]. In this population a past history of stroke (OR 1.8; 95% CI 1.4–2.3) [50] or other vascular diseases are risk factors for apathy [51]. The prevalence of apathy is significantly higher in demented patients [52].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, apathy was associated with cognitive and functional impairments in elders adjudged to have normal cognition [48]. It has been reported that up to a quarter of nondemented community-dwelling elderly individuals have apathy (most without concomitant depression) [50,51]. In this population a past history of stroke (OR 1.8; 95% CI 1.4–2.3) [50] or other vascular diseases are risk factors for apathy [51].…”

Section: Discussionmentioning

confidence: 99%

Apathy Secondary to Stroke: A Systematic Review and Meta-Analysis

2013

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Background: Apathy is a disturbance of motivation, frequent in survivors of stroke. Several studies have evaluated the rate of apathy secondary to stroke and risk factors. Different conclusions and contradictory findings have been published. We aimed to perform a systematic review and meta-analysis of all studies evaluating apathy secondary to stroke to better estimate its rate and risk factors, and explore associations with poorer outcomes. Methods: We searched PubMed, Cochrane Library, PsychINFO and PsycBITE databases and screened references of included studies and review articles for additional citations. Search results and data extraction was performed independently. We systematically reviewed available publications reporting investigations on ischemic and intracerebral hemorrhagic stroke and apathy. Quality assessment of the studies was performed independently. Subgroup analyses were performed according to stroke phase (acute and post-acute), stroke past history (first-ever and any-stroke) and patient age (younger and older patients). Pooled odds ratios (OR) and standardized mean difference, and 95% confidence intervals (CI), were derived by random-effects meta-analysis. Heterogeneity was assessed with I² test. Results: From the initial 1,399 publications, we included 19 studies (2,221 patients). The pooled rate of apathy was 36.3% (95% CI 30.3–42.8; I² = 46.8), which was similar for acute [39.5% (95% CI 28.9–51.1)] and post-acute phase [34.3% (95% CI 27.8–41.4)], and about three times higher than the rate of depression [12.1% (95% CI 8.2–17.3)]. Apathetic patients were on average 2.74 years older (95% CI 1.25–4.23; I² = 0%). No gender differences were found. Depression (OR 2.29; 95% CI 1.41–3.72; I² = 44%) and cognitive impairment (OR 2.90; 95% CI 1.09–7.72; I² = 14%) were more frequent and severe in apathetic patients. Apathy rate was similar for ischemic and hemorrhagic stroke type and for left- and right-sided hemispheric lesions. Clinical global outcome was similar between apathetic and nonapathetic patients. Conclusion: Apathy secondary to stroke is a more frequent neuropsychiatric disturbance than depression. Apathetic patients are more frequently and severely depressed and cognitively impaired. A negative impact of apathy secondary to stroke on clinical global outcome cannot be ascribed. Future research should properly address its predictor factors and evaluate the impact of apathy treatment options in stroke patients.

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Association of Vascular Factors With Apathy in Community-Dwelling Elderly Individuals

Ligthart¹,

Richard²,

Fransen³

et al. 2012

Arch Gen Psychiatry

125

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Vascular disease and apathy in old age. The Leiden 85‐plus Study

Abstract: In community dwelling elderly, those with vascular disease were at higher risk of developing apathy but not depression. This suggests that apathy and depression in old age have different etiologies.

Cited by 88 publications

References 40 publications

Symptoms of Apathy Are Associated with Progression from Mild Cognitive Impairment to Alzheimers Disease in Non-Depressed Subjects

Symptoms of Apathy Are Associated with Progression from Mild Cognitive Impairment to Alzheimers Disease in Non-Depressed Subjects

Apathy Secondary to Stroke: A Systematic Review and Meta-Analysis

Association of Vascular Factors With Apathy in Community-Dwelling Elderly Individuals

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Vascular disease and apathy in old age. The Leiden 85‐plus Study

Abstract: In community dwelling elderly, those with vascular disease were at higher risk of developing apathy but not depression. This suggests that apathy and depression in old age have different etiologies.

Cited by 88 publications

References 40 publications

Symptoms of Apathy Are Associated with Progression from Mild Cognitive Impairment to Alzheimers Disease in Non-Depressed Subjects

Symptoms of Apathy Are Associated with Progression from Mild Cognitive Impairment to Alzheimers Disease in Non-Depressed Subjects

Apathy Secondary to Stroke: A Systematic Review and Meta-Analysis

Association of Vascular Factors With Apathy in Community-Dwelling Elderly Individuals

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Product

Resources

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Symptoms of Apathy Are Associated with Progression from Mild Cognitive Impairment to Alzheimers Disease in Non-Depressed Subjects

Symptoms of Apathy Are Associated with Progression from Mild Cognitive Impairment to Alzheimers Disease in Non-Depressed Subjects