Apathy Is Associated With Greater Decline in Subjective, but not in Objective Measures of Physical Functioning in Older People Without Dementia

Henstra, Marieke; Feenstra, Thomas C; Velde, Nathalie van der; Mast, Roos C. van der; Comijs, Hannie C.; Stek, Max L.; Rhebergen, Didi

doi:10.1093/gerona/gly014

Cited by 15 publications

(22 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…First, a recent population-based study in non-demented older persons using data of two ongoing cohort studies (LonGenity (Ayers et al, 2014) and Central Control of Mobility in Aging [CCMA (Holtzer et al, 2014)]) it was demonstrated that independent of depressive symptoms, apathy was more strongly associated with self-reported disability than with performance-based physical decline at follow up (Ayers et al, 2017). Second, we previously demonstrated similar results, using data from the Netherlands Study of Depression in Older persons (NESDO)-cohort; in older persons without dementia, apathy was associated with decline of self-reported physical functioning but not with decline in performance-based tests after two years, irrespective of the presence of depression (Henstra et al, 2018). These results imply that reduced goal-directed activity (apathy) has a stronger negative impact on self-reported than performance-based measures of functional status.…”

Section: Introductionsupporting

confidence: 63%

“…Participants were asked to squeeze the dynamometer twice with their dominant hand in a standing position (Chung et al, 2014). For our analyses, the average of these two measurements was used (Henstra et al, 2018;2019). In order to combine the two performance-based tests, we divided the scores of both measures into quartiles and assigned a score of zero to the lowest functioning quartile, and a score of three to the highest functioning quartile.…”

Section: Assessment Of Performance-based Physical Functioningmentioning

confidence: 99%

See 1 more Smart Citation

Patterns of discordance of physical functioning in older persons; different associations for apathy and depression? Results from the NESDO-study

Henstra

Rhebergen

Velde

et al. 2021

Aging & Mental Health

Self Cite

View full text Add to dashboard Cite

Objectives: Discordance between self-reported functional limitations and performance-based physical functioning may have a negative impact in functional independence in older adults. We longitudinally examined baseline apathy-and depressive symptomatology as associates of discordance. Method: 469 participants from the multi-site cohort study NESDO were included. Self-reported functional limitations were assessed by two items derived from the WHO-Disability Assessment Schedule. Performance-based physical functioning included walking speed and handgrip-strength. Both measures were rescaled, with final sum-scores ranging from 0 to 6. Discordance-scores were computed by subtracting sum-scores on performance-based measures from self-reported functional limitations. Using latent growth curve analysis, we estimated individual trajectories of discordance at baseline, 2-and 6-years follow-up, consisting of the baseline discordance-score (intercept) and the yearly change of discordance-score (slope). We then estimated associations with apathy and depression indicators. Results: At baseline, persons (mean age 70.48 years, 65% female, 73% depressed) on average overestimated their daily functioning compared to performance tests (b = 0.77, p < 0.001). The average discordance-scores yearly increased by 0.15 (p < 0.001). Only in models adjusted for several demographic and clinical characteristics, depression severity was negatively associated with discordance-scores at baseline (b=−0.01, p = 0.02), while apathy was not (b=−0.02, p = 0.21). No associations with change over time were found. Conclusion:In older persons, not indifference and diminished goal-directed activity, but negative emotions appear to underlie underestimation of one's physical capacity. Further research is needed to determine (1) to what extent targeting discordance results in actual preservation of physical functioning and (2) whether older persons with apathy and/or depression need different approaches for this purpose.

show abstract

Section: Introductionsupporting

confidence: 63%

Section: Assessment Of Performance-based Physical Functioningmentioning

confidence: 99%

Patterns of discordance of physical functioning in older persons; different associations for apathy and depression? Results from the NESDO-study

Henstra

Rhebergen

Velde

et al. 2021

Aging & Mental Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…Indeed, apathy is associated with lower levels of physical activity 38,39 and reduced walking speed, 17 both of which are signs of physical frailty 3 . However, the possibility that apathy may affect self‐reported disability more than actual performance‐based physical dysfunction should be considered 39 . Previous studies have also reported that apathy is associated with the risk of cardiovascular disease, 22,40 which is closely related to the development of frailty 41 .…”

Section: Discussionmentioning

confidence: 99%

Associations between apathy and comprehensive frailty as assessed by the Kihon Checklist among community‐dwelling Japanese older adults

et al. 2022

View full text Add to dashboard Cite

Background Frailty is a multidimensional condition characterised by reduced physical and psychological resilience. Older adults also frequently demonstrate apathy, suggesting that it shares similar neuro‐physiological pathways with frailty. This cross‐sectional study aimed to investigate the association between apathy and frailty as defined by a comprehensive assessment. Methods We analyzed 882 older adults (mean age: 74.4 ± 6.4 years; 62.1% female) who participated in a community‐based health check survey (Tarumizu Study). Apathy was measured by the Geriatric Depression Scale‐3A, a three‐item subset of the Geriatric Depression Scale‐15, and frailty by the Kihon Checklist of physical, psychological, functional, and social status. Associations were examined by multinomial logistic regression with frailty status (robust, pre‐frailty, frailty) as the dependent variable, apathy as the independent variable, and sociodemographic factors, medications, cognitive function, functional capacity, and mood symptoms as potential confounders. Results Apathy was observed in 23.7% of individuals, and logistic regression revealed significant associations with both pre‐frailty and frailty after confounder adjustment (pre‐frailty: odds ratio (OR) 1.80, 95% CI 1.22–2.64; frailty: OR 3.24, 95% CI 1.63–6.42). Participants with apathy also exhibited greater deficits in the Kihon Checklist subdomains instrumental activities of daily living (P = 0.022), physical function (P < 0.001), oral function (P < 0.001), and cognitive function (P = 0.001). Conclusions Our findings underscore the importance of comprehensive frailty assessment and demonstrate that apathy can have pervasive deleterious effects on geriatric health.

show abstract

“…Consistent with other NPS, apathy is associated with poorer outcome in pre-dementia populations. Cross-sectionally, apathy in non-demented groups is associated with executive dysfunction, 18,38 poorer quality of life, 39 olfactory disturbance, 40 subjective impairments in physical functioning, 41 impairment in instrumental activities of daily living, 39 and greater family caregiver burden. 42 Longitudinally, apathy in non-demented individuals is associated with functional decline, 43 slowed gait and frailty, 44 and incident cognitive decline and dementia.…”

Section: Apathy In Pre-dementia Statesmentioning

confidence: 99%

Apathy as a Treatment Target in Alzheimer's Disease: Implications for Clinical Trials

Mortby

Adler

Agüera-Ortíz

et al. 2022

The American Journal of Geriatric Psychiatry

View full text Add to dashboard Cite

Apathy Is Associated With Greater Decline in Subjective, but not in Objective Measures of Physical Functioning in Older People Without Dementia

Cited by 15 publications

References 40 publications

Patterns of discordance of physical functioning in older persons; different associations for apathy and depression? Results from the NESDO-study

Patterns of discordance of physical functioning in older persons; different associations for apathy and depression? Results from the NESDO-study

Associations between apathy and comprehensive frailty as assessed by the Kihon Checklist among community‐dwelling Japanese older adults

Apathy as a Treatment Target in Alzheimer's Disease: Implications for Clinical Trials

Contact Info

Product

Resources

About