Depression and apathy in dementia: Same syndrome or different constructs? A critical review

Tagariello, P.; Girardi, Paolo; Amore, Mario

doi:10.1016/j.archger.2008.09.002

Cited by 134 publications

(125 citation statements)

References 26 publications

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“…Although depression and apathy often co-occur in AD, there is evidence suggesting distinct neurobiological roles and support for considering them as two distinct syndromes [15]. Depression is further complicated by the fact that it is a risk factor for other conditions, including vascular disease, diabetes, etc.…”

Section: Discussionmentioning

confidence: 99%

“…Apathy is a frequent neuropsychiatric disturbance in AD [15], which may be due to frontal dysfunction. A structural MRI study in AD [22] showed an association between apathy and medial frontal region structural abnormality.…”

Section: Discussionmentioning

confidence: 99%

“…Apathy and depression are prevalent in AD [15], and depression has been shown to increase neuropathological changes in the hippocampus at the time of AD diagnosis [16]. It has been hypothesized that depression may play a differential role in MCI, as depression itself can primarily cause cognitive deficits.…”

Section: Introductionmentioning

confidence: 99%

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Neuropsychiatric Predictors of Progression from Amnestic-Mild Cognitive Impairment to Alzheimer's Disease: The Role of Depression and Apathy

Palmer

Iulio

Varsi

et al. 2010

JAD

261

216

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Abstract. The aim of the study is to evaluate whether depression or apathy in patients with amnestic-mild cognitive impairment (MCI) increases the risk of progressing to Alzheimer's disease (AD). We investigated 131 consecutive memory-clinic outpatients with newly-diagnosed amnestic-MCI (mean age 70.8, SD = 6.5). Psychiatric disorders were diagnosed at baseline according to the criteria for depression and apathy in AD. Neuropsychiatric symptoms were assessed with the Neuropsychiatric Inventory (NPI). Follow-up examinations were conducted after six months and annually for four years. Neurologists diagnosed AD at follow-up using NINCDS-ADRDA criteria. Cox proportional hazard models with 95% confidence intervals were used to test the hypothesis that apathy or depression increases the risk of developing AD. At baseline, 36.6% amnestic-MCI patients had a diagnosis of depression and 10.7% had apathy. Patients with both amnestic-MCI and an apathy diagnosis had an almost sevenfold risk of AD progression compared to amnestic-MCI patients without apathy (HR = 6.9; 2.3-20.6), after adjustment for age, gender, education, baseline global cognitive and functional status, and depression. Furthermore, the risk of developing AD increased 30% per point on the NPI apathy item (HR = 1.3; 1.1-1.4). There was no increased risk of developing AD in amnestic-MCI patients with either a diagnosis or symptoms of depression. In conclusion, apathy, but not depression, predicts which patients with amnestic-MCI will progress to AD. Thus, apathy has an important impact on amnestic-MCI and should be considered a mixed cognitive/psychiatric disturbance related to ongoing AD neurodegeneration.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Neuropsychiatric Predictors of Progression from Amnestic-Mild Cognitive Impairment to Alzheimer's Disease: The Role of Depression and Apathy

Palmer

Iulio

Varsi

et al. 2010

JAD

261

216

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“…Due to the variable relationship of apathy and depression reported in literature there is a lack of consensus of the convergence of apathy and depression [57][58][59]. It would therefore be beneficial to examine how apathy subtypes and depression converge, as well as diverge, throughout disease progression to further understand the complex relationship between these behaviors.…”

Section: Discussionmentioning

confidence: 99%

A Novel Assessment and Profiling of Multidimensional Apathy in Alzheimer’s Disease

Radaković

Starr

Abrahams

2017

JAD

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“…Apathy and depression frequently occur together, but both can occur in absence of the other. The issue is still under debate, but mostly apathy is considered a separate syndrome (Starkstein et al 2005;Tagariello et al 2009). The different pattern and stability of apathy and depression found here support the view that apathy is a separate syndrome.…”

Section: Apathymentioning

confidence: 99%

Patterns and persistence of behavioural and psychological symptoms in those with cognitive impairment: the importance of apathy

Linde

Matthews

Dening

et al. 2016

Int J Geriat Psychiatry

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van der Linde, Rianne M. and Matthews, Fiona E. and Dening, Tom and Brayne, Carol (2016) Patterns and persistence of behavioural and psychological symptoms in those with cognitive impairment: the importance of apathy. International Journal of Geriatric Psychiatry . ISSN 0885-6230Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/33569/1/VanderLinde%20IJGP%20apathy_Revised %20Paper%20-%20changes%20accepted.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the University of Nottingham End User licence and may be reused according to the conditions of the licence. For more details see: http://eprints.nottingham.ac.uk/end_user_agreement.pdf A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. Table 1: One year transition rates taking into account age only Table 2: One-year mortality risk of those with a symptom compared to those without Table 3 Table 1: Baseline prevalence of symptoms, including how many are excluded because single transition Online Additional Table 2: Baseline characteristics Online Additional Table 3: Symptom presence, missing values, loss to follow-up and drop out due to death across the follow-up period Online Additional Table 4: Number of transitions for each of the symptoms Online Additional Table 5 Hazard ratio of the association between symptom history and transition rates in those with at least 2 interviews Online Additional Table 6 Sensitivity analysis comparing transition rates for an apathy definition based on participant interviews only to transition rates based on both participant and informant interviews 3 AbstractObjective To study the stability and emergence of a range of Behavioural and Psychological Symptoms (BPS), their association with mortality and the effect of covariates on these transitions in a population based study of cognitively impaired older people with a long follow-up period and large sample size, with a particular focus on apathy.Methods Data were from a population-based, longitudinal cohort study of ageing.Interviews were conducted at 0, 2, 6, 8 and 10 years with 3,626 participants aged 65+.The persistence of 11 BPS and their association with mortality in those with cognitive impairment (MMSE 25 or below) was investigated using multistate models, allowing us to take into account estimations of the probability of transitions that occurred in the time between interviews.Results Most BPS were persistent. Apathy was one of the most stable symptoms; in those with apathy, the probability of still having apathy after 1 year is 62%. Apathy, sleep problems, depression, irritability and wandering were most likely...

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Depression and apathy in dementia: Same syndrome or different constructs? A critical review

Cited by 134 publications

References 26 publications

Neuropsychiatric Predictors of Progression from Amnestic-Mild Cognitive Impairment to Alzheimer's Disease: The Role of Depression and Apathy

Neuropsychiatric Predictors of Progression from Amnestic-Mild Cognitive Impairment to Alzheimer's Disease: The Role of Depression and Apathy

A Novel Assessment and Profiling of Multidimensional Apathy in Alzheimer’s Disease

Patterns and persistence of behavioural and psychological symptoms in those with cognitive impairment: the importance of apathy

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