Apathy and cognitive and functional decline in community-dwelling older adults: Results from the Baltimore ECA longitudinal study

Diana E. Clarke, Jean Y. Ko, Constantine G Lyketsos, George Rebok, William W Eaton

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)819-829
Number of pages11
JournalInternational Psychogeriatrics
Volume22
Issue number5
DOIs
StatePublished - Aug 2010

Fingerprint

Independent Living
Apathy
Baltimore
Longitudinal Studies
Cognitive Dysfunction
Alzheimer Disease
Public Health
Logistic Models
Depression
Education

Keywords

  • apathy correlates
  • Basic and Instrumental Activities of Daily Living
  • MMSE

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Gerontology
  • Clinical Psychology
  • Medicine(all)

Cite this

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title = "Apathy and cognitive and functional decline in community-dwelling older adults: Results from the Baltimore ECA longitudinal study",
abstract = "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.",
keywords = "apathy correlates, Basic and Instrumental Activities of Daily Living, MMSE",
author = "Clarke, {Diana E.} and Ko, {Jean Y.} and Lyketsos, {Constantine G} and George Rebok and Eaton, {William W}",
year = "2010",
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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 G

AU - Rebok, George

AU - Eaton, William W

PY - 2010/8

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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.

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