A prospective longitudinal study of apathy in Alzheimer’s disease

• Published in: Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 2006-01, Vol.77 (1), p.8-11
• Main Authors: Starkstein, S E, Jorge, R, Mizrahi, R, Robinson, R G
• Format: Article
• Language: English
• Subjects: 4th edition; Activities of daily living; ADL; Aged; Alzheimer Disease - complications; Alzheimer Disease - psychology; Alzheimer's disease; anosognosia; apathy; Apathy Scale; Biological and medical sciences; Caregivers; CDR; Clinical Dementia Rating; Cognition & reasoning; Cognition Disorders - complications; Cognition Disorders - diagnosis; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; depression; Depression - diagnosis; Depression - etiology; Diagnostic and statistical manual of mental disorders; DSM-IV; Female; FIM; Follow-Up Studies; Functioning Independence Measure; Hachinski Ischemic Score; HAM-D; Hamilton depression scale; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; HIS; Humans; Hypotheses; Male; Medical research; Medical sciences; Mental depression; Mini Mental State Examination; MMSE; Nervous system (semeiology, syndromes); Neurology; Neuropsychological Tests; Prospective Studies; Psychiatrists; SCID; Statistical analysis; Structured Clinical Interview for DSM-IV; Studies; Surveys and Questionnaires; Validity
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2005.069575

Background: Apathy and depression are the most frequent behavioural and psychiatric disorders in Alzheimer’s disease, and may both have a negative impact on the progression of the illness. Objectives: To examine the clinical correlates of apathy in Alzheimer’s disease (AD), and to determine whether apathy is a significant predictor of more rapid cognitive, functional and emotional decline. Methods: Using a structured psychiatric evaluation, we examined a consecutive series of 354 subjects meeting clinical criteria for AD. Apathy was assessed by the Apathy Scale, and diagnosed using standardised criteria. Additional measurements included scales for depression, functional impairment, and global cognitive functions. A follow up evaluation was carried out in 247 patients (70% of the total sample) between 1 and 4 years after the baseline evaluation. Results: Apathy was significantly associated with older age (p = 0.009), and a higher frequency of minor and major depression (p