Apathy Is Associated with Activities of Daily Living Ability in Parkinson's Disease

Abstract

Background: Neuropsychiatric symptoms and impairment in performing activities of daily living (ADL) in patients with Parkinson's disease (PD) are strong predictors of the overall caregiver burden and they increase the risk for nursing home admission of the patients. The purpose of the present study was to assess the association of neuropsychiatric symptoms and ADL functions in PD. Methods: A total of 73 community-dwelling PD patients were studied. The mean age of the patient group was 65 years and the mean disease duration was 9 years. The Neuropsychiatric Inventory was used to measure neuropsychiatric symptoms, and ADL abilities were measured by the Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory. Results: The prevalence of neuropsychiatric symptoms in patients with PD was 73%. The most common symptoms were depression, anxiety, irritability, apathy and agitation. ADL ability correlated significantly with apathy (p < 0.002) even when adjusted for motor symptoms. Conclusion: Apathy was significantly associated with ADL in PD. The result indicates that more attention should be paid to identifying apathy and targeting therapeutic interventions.

Apathy in Parkinson's disease: A systematic review and meta‐analysis

“…Apathy was associated with lower MMSE scores in 7 of 10 cohorts reporting on the subject, and with a worse Montreal Cognitive Assessment score in another . Separate meta‐analysis regarding MMSE score was possible based on nine cohorts . Patients with apathy on average had a 1.4‐point lower MMSE score (95% CI = −2.1‐0.8, I 2 = 61%, Fig.…”

“…Apathy was associated with longer disease duration in 2 of 11 cohorts reporting on the subject . Separate meta‐analysis on disease duration was possible based on eight cohorts . No significant difference in disease duration was found between patients with and without apathy (Fig.…”

“…Exclusion of one outlier slightly attenuated the difference to 2.7 years (I 2 = 44%, Supplemental Data s‐6) . Male sex was associated with apathy in 2 of 12 cohorts reporting on the subject . Separate meta‐analysis on the association between apathy and sex was possible based on 10 cohorts .…”

“…More sensitive cutoff points were used in one study employing the LARS (≥–22), and five studies employing the NPI (≥1) . Three studies reported prevalence rates for both the ≥1 and the ≥4 point cutoff points on the NPI . In one study, apathy prevalence was measured using the NPI (≥4), LARS (≥16), and a clinical diagnosis, but only the clinical diagnosis was available for subanalyses …”

Apathy in Parkinson's disease: clinical features, neural substrates, diagnosis, and treatment

“…Apathy in Parkinson's disease has also been related to more severe motor impairment, worse executive dysfunction, and a higher risk of develop ing dementia than Parkinson's disease without apathy. 50,51 As such, apathy is a key symptom of the worsening of Parkinson's disease as the disease progresses, predictive of decreased functioning in activities of daily living, 52 decreased response to treatment, poor outcome, and diminished quality of life, 43,50,53 and it is a major contributor to caregiver emotional distress. 54 The multidimensional nature of apathy A patient started to develop symptoms of Parkinson's disease at age 46 years, with a prodromal phase characterised by a complete hypodopaminergic behavioural syndrome.…”