TY - JOUR
T1 - Apathy and cognitive and functional decline in community-dwelling older adults
T2 - Results from the Baltimore ECA longitudinal study
AU - Clarke, Diana E.
AU - Ko, Jean Y.
AU - Lyketsos, Constantine
AU - Rebok, George W.
AU - Eaton, William W.
PY - 2010/8
Y1 - 2010/8
N2 - Background: Apathy, a complex neuropsychiatric syndrome, commonly affects patients with Alzheimer's disease. Prevalence estimates for apathy range widely and are based on cross-sectional data and/or clinic samples. This study examines the relationships between apathy and cognitive and functional declines in non-depressed community-based older adults. Methods: Data on 1,136 community-dwelling adults aged 50 years and older from the Baltimore Epidemiologic Catchment Area (ECA) study, with 1 and 13 years of follow-up, were used. Apathy was assessed with a subscale of items from the General Health Questionnaire. Logistic regression, t-tests, 2 and Generalized Estimating Equations were used to accomplish the study's objectives. Results: The prevalence of apathy at Wave 1 was 23.7%. Compared to those without, individuals with apathy were on average older, more likely to be female, and have lower Mini-mental State Examination (MMSE) scores and impairments in basic and instrumental functioning at baseline. Apathy was significantly associated with cognitive decline (OR = 1.65, 95% CI = 1.06, 2.60) and declines in instrumental (OR = 4.42; 95% CI = 2.65, 7.38) and basic (OR = 2.74; 95%CI = 1.35, 5.57) function at 1-year follow-up, even after adjustment for baseline age, level of education, race, and depression at follow-up. At 13 years of follow-up, apathetic individuals were not at greater risk for cognitive decline but were twice as likely to have functional decline. Incidence of apathy at 1-year follow up and 13-year follow-up was 22.6% and 29.4%, respectively. Conclusions: These results underline the public health importance of apathy and the need for further population-based studies in this area.
AB - Background: Apathy, a complex neuropsychiatric syndrome, commonly affects patients with Alzheimer's disease. Prevalence estimates for apathy range widely and are based on cross-sectional data and/or clinic samples. This study examines the relationships between apathy and cognitive and functional declines in non-depressed community-based older adults. Methods: Data on 1,136 community-dwelling adults aged 50 years and older from the Baltimore Epidemiologic Catchment Area (ECA) study, with 1 and 13 years of follow-up, were used. Apathy was assessed with a subscale of items from the General Health Questionnaire. Logistic regression, t-tests, 2 and Generalized Estimating Equations were used to accomplish the study's objectives. Results: The prevalence of apathy at Wave 1 was 23.7%. Compared to those without, individuals with apathy were on average older, more likely to be female, and have lower Mini-mental State Examination (MMSE) scores and impairments in basic and instrumental functioning at baseline. Apathy was significantly associated with cognitive decline (OR = 1.65, 95% CI = 1.06, 2.60) and declines in instrumental (OR = 4.42; 95% CI = 2.65, 7.38) and basic (OR = 2.74; 95%CI = 1.35, 5.57) function at 1-year follow-up, even after adjustment for baseline age, level of education, race, and depression at follow-up. At 13 years of follow-up, apathetic individuals were not at greater risk for cognitive decline but were twice as likely to have functional decline. Incidence of apathy at 1-year follow up and 13-year follow-up was 22.6% and 29.4%, respectively. Conclusions: These results underline the public health importance of apathy and the need for further population-based studies in this area.
KW - Basic and Instrumental Activities of Daily Living
KW - MMSE
KW - apathy correlates
UR - http://www.scopus.com/inward/record.url?scp=77957333235&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77957333235&partnerID=8YFLogxK
U2 - 10.1017/S1041610209991402
DO - 10.1017/S1041610209991402
M3 - Article
C2 - 20478091
AN - SCOPUS:77957333235
SN - 1041-6102
VL - 22
SP - 819
EP - 829
JO - International psychogeriatrics
JF - International psychogeriatrics
IS - 5
ER -