Measuring Apathy in Alzheimer's Disease in the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2): A Comparison of Instruments

Krista L. Lanctôt; Roberta W. Scherer; Abby Li; Danielle Vieira; Hamadou Coulibaly; Paul B. Rosenberg; Nathan Herrmann; Alan J. Lerner; Prasad R. Padala; Olga Brawman-Mintzer; Chris H. van Dyck; Anton P. Porsteinsson; Suzanne Craft; Allan Levey; William J. Burke; Jacobo E. Mintzer

doi:10.1016/j.jagp.2020.05.020

Measuring Apathy in Alzheimer's Disease in the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2): A Comparison of Instruments

Krista L. Lanctôt, Roberta W. Scherer, Abby Li, Danielle Vieira, Hamadou Coulibaly, Paul B. Rosenberg, Nathan Herrmann, Alan J. Lerner, Prasad R. Padala, Olga Brawman-Mintzer, Chris H. van Dyck, Anton P. Porsteinsson, Suzanne Craft, Allan Levey, William J. Burke, Jacobo E. Mintzer

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Diagnostic criteria for apathy have been published but have yet to be evaluated in the context of clinical trials. The Apathy in Dementia Methylphenidate Trial 2 (ADMET 2) operationalized the diagnostic criteria for apathy (DCA) into a clinician-rated questionnaire informed by interviews with the patient and caregiver. Objective: The goal of the present study was to compare the classification of apathy using the DCA with that using the Neuropsychiatric Inventory-apathy (NPI-apathy) subscale in ADMET 2. Comparisons between NPI-Apathy and Dementia Apathy Interview Rating (DAIR) scale, and DCA and DAIR were also explored. Methods: ADMET 2 is a randomized, double-blind, placebo-controlled phase III trial examining the effects of 20 mg/day methylphenidate on symptoms of apathy over 6 months in patients with mild to moderate Alzheimer's disease (AD). Participants scoring at least 4 on the NPI-Apathy were recruited. This analysis focuses on cross-sectional correlations between baseline apathy scale scores using cross-tabulation. Results: Of 180 participants, the median age was 76.5 years and they were predominantly white (92.8%) and male (66.1%). The mean (±standard deviation) scores were 7.7 ± 2.4 on the NPI-apathy, and 1.9 ± 0.5 on the DAIR. Of those with NPI-defined apathy, 169 (93.9%, 95% confidence interval [CI] 89.3%–96.9%) met DCA diagnostic criteria. The DCA and DAIR overlapped on apathy diagnosis for 169 participants (93.9%, 95% CI 89.3%–96.9%). Conclusion: The measurements used for the assessment of apathy in patients with AD had a high degree of overlap with the DCA. The NPI-apathy cut-off used to determine apathy in ADMET 2 selects those likely to meet DCA criteria.

Original language	English (US)
Pages (from-to)	81-89
Number of pages	9
Journal	American Journal of Geriatric Psychiatry
Volume	29
Issue number	1
DOIs	https://doi.org/10.1016/j.jagp.2020.05.020
State	Published - Jan 2021

Keywords

Alzheimer's disease
apathy
dementia
diagnostic criteria
methylphenidate
neuropsychiatric inventory

ASJC Scopus subject areas

Geriatrics and Gerontology
Psychiatry and Mental health

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10.1016/j.jagp.2020.05.020

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Lanctôt, K. L., Scherer, R. W., Li, A., Vieira, D., Coulibaly, H., Rosenberg, P. B., Herrmann, N., Lerner, A. J., Padala, P. R., Brawman-Mintzer, O., van Dyck, C. H., Porsteinsson, A. P., Craft, S., Levey, A., Burke, W. J., & Mintzer, J. E. (2021). Measuring Apathy in Alzheimer's Disease in the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2): A Comparison of Instruments. American Journal of Geriatric Psychiatry, 29(1), 81-89. https://doi.org/10.1016/j.jagp.2020.05.020

Lanctôt, KL, Scherer, RW, Li, A, Vieira, D, Coulibaly, H, Rosenberg, PB, Herrmann, N, Lerner, AJ, Padala, PR, Brawman-Mintzer, O, van Dyck, CH, Porsteinsson, AP, Craft, S, Levey, A, Burke, WJ & Mintzer, JE 2021, 'Measuring Apathy in Alzheimer's Disease in the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2): A Comparison of Instruments', American Journal of Geriatric Psychiatry, vol. 29, no. 1, pp. 81-89. https://doi.org/10.1016/j.jagp.2020.05.020

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title = "Measuring Apathy in Alzheimer's Disease in the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2): A Comparison of Instruments",

abstract = "Background: Diagnostic criteria for apathy have been published but have yet to be evaluated in the context of clinical trials. The Apathy in Dementia Methylphenidate Trial 2 (ADMET 2) operationalized the diagnostic criteria for apathy (DCA) into a clinician-rated questionnaire informed by interviews with the patient and caregiver. Objective: The goal of the present study was to compare the classification of apathy using the DCA with that using the Neuropsychiatric Inventory-apathy (NPI-apathy) subscale in ADMET 2. Comparisons between NPI-Apathy and Dementia Apathy Interview Rating (DAIR) scale, and DCA and DAIR were also explored. Methods: ADMET 2 is a randomized, double-blind, placebo-controlled phase III trial examining the effects of 20 mg/day methylphenidate on symptoms of apathy over 6 months in patients with mild to moderate Alzheimer's disease (AD). Participants scoring at least 4 on the NPI-Apathy were recruited. This analysis focuses on cross-sectional correlations between baseline apathy scale scores using cross-tabulation. Results: Of 180 participants, the median age was 76.5 years and they were predominantly white (92.8%) and male (66.1%). The mean (±standard deviation) scores were 7.7 ± 2.4 on the NPI-apathy, and 1.9 ± 0.5 on the DAIR. Of those with NPI-defined apathy, 169 (93.9%, 95% confidence interval [CI] 89.3%–96.9%) met DCA diagnostic criteria. The DCA and DAIR overlapped on apathy diagnosis for 169 participants (93.9%, 95% CI 89.3%–96.9%). Conclusion: The measurements used for the assessment of apathy in patients with AD had a high degree of overlap with the DCA. The NPI-apathy cut-off used to determine apathy in ADMET 2 selects those likely to meet DCA criteria.",

keywords = "Alzheimer's disease, apathy, dementia, diagnostic criteria, methylphenidate, neuropsychiatric inventory",

author = "Lanct{\^o}t, {Krista L.} and Scherer, {Roberta W.} and Abby Li and Danielle Vieira and Hamadou Coulibaly and Rosenberg, {Paul B.} and Nathan Herrmann and Lerner, {Alan J.} and Padala, {Prasad R.} and Olga Brawman-Mintzer and {van Dyck}, {Chris H.} and Porsteinsson, {Anton P.} and Suzanne Craft and Allan Levey and Burke, {William J.} and Mintzer, {Jacobo E.}",

note = "Publisher Copyright: {\textcopyright} 2020 American Association for Geriatric Psychiatry",

year = "2021",

month = jan,

doi = "10.1016/j.jagp.2020.05.020",

language = "English (US)",

volume = "29",

pages = "81--89",

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T1 - Measuring Apathy in Alzheimer's Disease in the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2)

T2 - A Comparison of Instruments

AU - Lanctôt, Krista L.

AU - Scherer, Roberta W.

AU - Li, Abby

AU - Vieira, Danielle

AU - Coulibaly, Hamadou

AU - Rosenberg, Paul B.

AU - Herrmann, Nathan

AU - Lerner, Alan J.

AU - Padala, Prasad R.

AU - Brawman-Mintzer, Olga

AU - van Dyck, Chris H.

AU - Porsteinsson, Anton P.

AU - Craft, Suzanne

AU - Levey, Allan

AU - Burke, William J.

AU - Mintzer, Jacobo E.

PY - 2021/1

Y1 - 2021/1

N2 - Background: Diagnostic criteria for apathy have been published but have yet to be evaluated in the context of clinical trials. The Apathy in Dementia Methylphenidate Trial 2 (ADMET 2) operationalized the diagnostic criteria for apathy (DCA) into a clinician-rated questionnaire informed by interviews with the patient and caregiver. Objective: The goal of the present study was to compare the classification of apathy using the DCA with that using the Neuropsychiatric Inventory-apathy (NPI-apathy) subscale in ADMET 2. Comparisons between NPI-Apathy and Dementia Apathy Interview Rating (DAIR) scale, and DCA and DAIR were also explored. Methods: ADMET 2 is a randomized, double-blind, placebo-controlled phase III trial examining the effects of 20 mg/day methylphenidate on symptoms of apathy over 6 months in patients with mild to moderate Alzheimer's disease (AD). Participants scoring at least 4 on the NPI-Apathy were recruited. This analysis focuses on cross-sectional correlations between baseline apathy scale scores using cross-tabulation. Results: Of 180 participants, the median age was 76.5 years and they were predominantly white (92.8%) and male (66.1%). The mean (±standard deviation) scores were 7.7 ± 2.4 on the NPI-apathy, and 1.9 ± 0.5 on the DAIR. Of those with NPI-defined apathy, 169 (93.9%, 95% confidence interval [CI] 89.3%–96.9%) met DCA diagnostic criteria. The DCA and DAIR overlapped on apathy diagnosis for 169 participants (93.9%, 95% CI 89.3%–96.9%). Conclusion: The measurements used for the assessment of apathy in patients with AD had a high degree of overlap with the DCA. The NPI-apathy cut-off used to determine apathy in ADMET 2 selects those likely to meet DCA criteria.

AB - Background: Diagnostic criteria for apathy have been published but have yet to be evaluated in the context of clinical trials. The Apathy in Dementia Methylphenidate Trial 2 (ADMET 2) operationalized the diagnostic criteria for apathy (DCA) into a clinician-rated questionnaire informed by interviews with the patient and caregiver. Objective: The goal of the present study was to compare the classification of apathy using the DCA with that using the Neuropsychiatric Inventory-apathy (NPI-apathy) subscale in ADMET 2. Comparisons between NPI-Apathy and Dementia Apathy Interview Rating (DAIR) scale, and DCA and DAIR were also explored. Methods: ADMET 2 is a randomized, double-blind, placebo-controlled phase III trial examining the effects of 20 mg/day methylphenidate on symptoms of apathy over 6 months in patients with mild to moderate Alzheimer's disease (AD). Participants scoring at least 4 on the NPI-Apathy were recruited. This analysis focuses on cross-sectional correlations between baseline apathy scale scores using cross-tabulation. Results: Of 180 participants, the median age was 76.5 years and they were predominantly white (92.8%) and male (66.1%). The mean (±standard deviation) scores were 7.7 ± 2.4 on the NPI-apathy, and 1.9 ± 0.5 on the DAIR. Of those with NPI-defined apathy, 169 (93.9%, 95% confidence interval [CI] 89.3%–96.9%) met DCA diagnostic criteria. The DCA and DAIR overlapped on apathy diagnosis for 169 participants (93.9%, 95% CI 89.3%–96.9%). Conclusion: The measurements used for the assessment of apathy in patients with AD had a high degree of overlap with the DCA. The NPI-apathy cut-off used to determine apathy in ADMET 2 selects those likely to meet DCA criteria.

KW - Alzheimer's disease

KW - apathy

KW - dementia

KW - diagnostic criteria

KW - methylphenidate

KW - neuropsychiatric inventory

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Measuring Apathy in Alzheimer's Disease in the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2): A Comparison of Instruments

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Keywords

ASJC Scopus subject areas

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