Association between apathy and satisfaction with meaningful activities in older adults with mild cognitive impairment: A population‐based cross‐sectional study

Abstract

Objectives This cross‐sectional study aimed to clarify the relationship between apathy, meaningful activities, and satisfaction with such activities of older adults with mild cognitive impairment (MCI). Methods We analyzed 235 older adults with MCI (≥65 years, mean age: 76.9 ± 6.4 years, women: 63.4%) who participated in a community‐based health check survey (Tarumizu Study 2018). MCI was defined as at least 1.5 SD below the reference threshold (age‐ and education‐adjusted score) on one or more of the computerized cognitive test including memory, attention, executive functions, and processing speed. Apathy symptoms were assessed using three of the 15 items of Geriatric Depression Scale. Participants selected meaningful activities from the 95 activities of the Aid for Decision‐Making in Occupation Choice and evaluated their satisfaction and performance. Results Apathy in MCI was prevalent by 23.8%. The categories of meaningful activities revealed no difference, with, or without apathy. Logistic regression analysis showed that activity satisfaction was significantly associated with apathy after adjusting for age, sex, education, instrumental activities of daily living, depressive symptoms, and MCI subtype (OR, 0.62; 95% CI, 0.44–0.88, p = 0.008). Conclusions Satisfaction with the activities that are deemed meaningful is associated with apathy among community‐dwelling older adults with MCI.

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

“…Several limitations to our study should be noted. First, although many cohort studies have used the GDS-3A to define apathy, [20][21][22][23][24] it demonstrates only fair sensitivity and specificity, 20 so there is a risk of misclassification bias. While formal psychiatric assessment is desirable, 51 it is difficult in large cohort setting.…”

“…Apathy was measured using the following three items of the Geriatric Depression Scale-15 (GDS-15), termed GDS-3A, as previously described. [20][21][22][23][24] The three items were as follows: (i) 'Have you dropped many of your activities and interests?' (Yes = 1 point); (ii) 'Do you prefer to stay at home, rather than going out and doing new things?'…”

“…A score ≥2 points was defined as indicative of apathy. 20,21,24 These three questions in GDS-15 represent apathy symptoms according to the consensus opinion of an expert panel including psychiatrists, behavioural neurologists, and neuropsychologists. 20…”

“…25,26 It has also been translated into many languages, including English, 27 Spanish, 28 Brazilian Portuguese, 29 Chinese, 30 and Turkish, 31 making it suitable for cross-cultural studies. 26 The 25 items cover the following seven domains: instrumental ADL (IADL; questions 1-5), physical function (questions 6-10), nutritional status (questions 11-12), oral function (questions 13-15), social isolation (questions [16][17], cognitive function (questions 18-20), and depressive mood (questions [21][22][23][24][25]. The depressive mood domain includes questions synonymous with those of the GDS-3A (e.g., Have you felt a lack of joy when doing the things you used to enjoy?…”

Non-pharmacological intervention effects on apathy caused by central nervous system organic diseases: A network meta-analysis

“…[2] Apathy is a common symptom of central nervous system (CNS) organic diseases, such as stroke, Parkinson disease, dementia and mild cognitive impairment. [3–6] Study [7] shows that apathy is due to damage or disruption to goal-directed areas of the brain, such as the limbic system, frontal, basal ganglia, temporal, parietal, insula, occipital, et al Increasing evidences suggest that apathy is severely affecting patients’ participation in rehabilitation, [8] accelerating the process of cognitive decline, [9] reducing the patient’s ability to take care of themselves, [10] also affecting their quality of life, [11] and even increasing the patient’s chance of suicide. [12] The mechanism of apathy occurrence is not yet fully understood.…”