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Published in: Alzheimer's Research & Therapy 1/2018

Open Access 01-12-2018 | Research

Apathy is associated with faster global cognitive decline and early nursing home admission in dementia with Lewy bodies

Authors: Monica H. Breitve, Kolbjørn Brønnick, Luiza J. Chwiszczuk, Minna J. Hynninen, Dag Aarsland, Arvid Rongve

Published in: Alzheimer's Research & Therapy | Issue 1/2018

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Abstract

Background

Little is known about the consequences of apathy in dementia with Lewy bodies (DLB), because previous research on apathy in dementia focused mainly on Alzheimer’s disease (AD).

Methods

In this longitudinal study, we included patients with AD (n = 128) and patients with DLB (n = 81). At baseline, we analyzed the associations between apathy and cognition in the total sample and in AD and DLB separately. Generalized linear mixed models were used to investigate the association between apathy and Mini Mental State Examination (MMSE) over 4 years, and the Kaplan-Meier method was used to assess the association between apathy and survival or nursing home admission.

Results

In patients with DLB, apathy was associated with a faster global cognitive decline (MMSE) over 4 years. Patients with DLB and apathy had shorter time until nursing home admission than DLB patients without apathy and patients with AD, regardless of apathy. At baseline, patients with apathy had decreased performance on the Stroop color test and a composite executive function score. Neurocognition was unaffected by apathy in AD, but DLB patients with apathy had more verbal learning difficulties.

Conclusions

Apathy seems to be associated with more serious symptomatology in DLB than in AD. It is important to focus on apathy in dementia because it is one of the most prevalent and disturbing behavioral and psychological symptoms.
Literature
6.
go back to reference Levy ML, Miller BL, Cummings JL, Fairbanks LA, Craig A. Alzheimer disease and frontotemporal dementias. behavioral distinctions. Arch Neurol. 1996;53(7):687–90.CrossRefPubMed Levy ML, Miller BL, Cummings JL, Fairbanks LA, Craig A. Alzheimer disease and frontotemporal dementias. behavioral distinctions. Arch Neurol. 1996;53(7):687–90.CrossRefPubMed
7.
go back to reference Starkstein SE, Jorge R, Mizrahi R, Robinson RG. A prospective longitudinal study of apathy in Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2006;77(1):8–11.CrossRefPubMedPubMedCentral Starkstein SE, Jorge R, Mizrahi R, Robinson RG. A prospective longitudinal study of apathy in Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2006;77(1):8–11.CrossRefPubMedPubMedCentral
8.
go back to reference Landes AM, Sperry SD, Strauss ME, Geldmacher DS. Apathy in Alzheimer’s disease. J Am Geriatr Soc. 2001;49(12):1700–7.CrossRefPubMed Landes AM, Sperry SD, Strauss ME, Geldmacher DS. Apathy in Alzheimer’s disease. J Am Geriatr Soc. 2001;49(12):1700–7.CrossRefPubMed
10.
go back to reference van der Linde RM, Dening T, Stephan BC, Prina AM, Evans E, Brayne C. Longitudinal course of behavioural and psychological symptoms of dementia: systematic review. Br J Psychiatry. 2016;209(5):366–77.CrossRefPubMedPubMedCentral van der Linde RM, Dening T, Stephan BC, Prina AM, Evans E, Brayne C. Longitudinal course of behavioural and psychological symptoms of dementia: systematic review. Br J Psychiatry. 2016;209(5):366–77.CrossRefPubMedPubMedCentral
12.
go back to reference Starkstein SE, Ingram L, Garau ML, Mizrahi R. On the overlap between apathy and depression in dementia. J Neurol Neurosurg Psychiatry. 2005;76(8):1070–4.CrossRefPubMedPubMedCentral Starkstein SE, Ingram L, Garau ML, Mizrahi R. On the overlap between apathy and depression in dementia. J Neurol Neurosurg Psychiatry. 2005;76(8):1070–4.CrossRefPubMedPubMedCentral
13.
go back to reference Kuzis G, Sabe L, Tiberti C, Dorrego F, Starkstein SE, Neuropsychological correlates of apathy and depression in patients with dementia. Neurology. 1999;52(7):1403–7.CrossRefPubMed Kuzis G, Sabe L, Tiberti C, Dorrego F, Starkstein SE, Neuropsychological correlates of apathy and depression in patients with dementia. Neurology. 1999;52(7):1403–7.CrossRefPubMed
17.
go back to reference Perri R, Monaco M, Fadda L, Caltagirone C, Carlesimo GA. Neuropsychological correlates of behavioral symptoms in Alzheimer’s disease, frontal variant of frontotemporal, subcortical vascular, and Lewy body dementias: a comparative study. J Alzheimers Dis. 2014;39(3):669–77. https://doi.org/10.3233/JAD-131337.CrossRefPubMed Perri R, Monaco M, Fadda L, Caltagirone C, Carlesimo GA. Neuropsychological correlates of behavioral symptoms in Alzheimer’s disease, frontal variant of frontotemporal, subcortical vascular, and Lewy body dementias: a comparative study. J Alzheimers Dis. 2014;39(3):669–77. https://​doi.​org/​10.​3233/​JAD-131337.CrossRefPubMed
18.
go back to reference McPherson S, Fairbanks L, Tiken S, Cummings JL, Back-Madruga C. Apathy and executive function in Alzheimer’s disease. J Int Neuropsychol Soc. 2002;8(3):373–81.CrossRefPubMed McPherson S, Fairbanks L, Tiken S, Cummings JL, Back-Madruga C. Apathy and executive function in Alzheimer’s disease. J Int Neuropsychol Soc. 2002;8(3):373–81.CrossRefPubMed
22.
go back to reference Bakker C, de Vugt ME, van Vliet D, Verhey FRJ, Pijnenburg YA, Vernooij-Dassen MJFJ, et al. Predictors of the time to institutionalization in young- versus late-onset dementia: results from the Needs in Young Onset Dementia (NeedYD) study. J Am Med Dir Assoc. 2013;14:248–53.CrossRefPubMed Bakker C, de Vugt ME, van Vliet D, Verhey FRJ, Pijnenburg YA, Vernooij-Dassen MJFJ, et al. Predictors of the time to institutionalization in young- versus late-onset dementia: results from the Needs in Young Onset Dementia (NeedYD) study. J Am Med Dir Assoc. 2013;14:248–53.CrossRefPubMed
23.
go back to reference Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.CrossRefPubMed Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.CrossRefPubMed
24.
go back to reference Morris JC. Clinical Dementia Rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. Int Psychogeriatr. 1997;9(Suppl 1):173–6. discussion 177–8CrossRefPubMed Morris JC. Clinical Dementia Rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. Int Psychogeriatr. 1997;9(Suppl 1):173–6. discussion 177–8CrossRefPubMed
25.
go back to reference McKeith IG, Dickson DW, Lowe J, Emre M, O’Brien JT, Feldman H, et al. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology. 2005;65(12):1863–72.CrossRefPubMed McKeith IG, Dickson DW, Lowe J, Emre M, O’Brien JT, Feldman H, et al. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology. 2005;65(12):1863–72.CrossRefPubMed
26.
go back to reference McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology. 1984;34(7):939–44.CrossRefPubMed McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology. 1984;34(7):939–44.CrossRefPubMed
27.
go back to reference Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44:2308–14.CrossRefPubMed Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44:2308–14.CrossRefPubMed
28.
go back to reference Goetz CG, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stebbins GT, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): process, format, and clinimetric testing plan. Mov Disord. 2007;22(1):41–7.CrossRefPubMed Goetz CG, Fahn S, Martinez-Martin P, Poewe W, Sampaio C, Stebbins GT, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): process, format, and clinimetric testing plan. Mov Disord. 2007;22(1):41–7.CrossRefPubMed
29.
go back to reference Miller MD, Paradis CF, Houck PR, Mazumdar S, Stack JA, Rifai AH, et al. Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale. Psychiatry Res. 1992;41(3):237–48.CrossRefPubMed Miller MD, Paradis CF, Houck PR, Mazumdar S, Stack JA, Rifai AH, et al. Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale. Psychiatry Res. 1992;41(3):237–48.CrossRefPubMed
30.
go back to reference Mack WJ, Freed DM, Williams BW, Henderson VW. Boston Naming Test: shortened versions for use in Alzheimer’s disease. J Gerontol. 1992;47(3):154–8.CrossRef Mack WJ, Freed DM, Williams BW, Henderson VW. Boston Naming Test: shortened versions for use in Alzheimer’s disease. J Gerontol. 1992;47(3):154–8.CrossRef
31.
go back to reference Golden CJ. Stroop Colour and Word Test. Chicago: Stoelting; 1978. Golden CJ. Stroop Colour and Word Test. Chicago: Stoelting; 1978.
32.
go back to reference Benton AL, Hamsher K. Multilingual aphasia examination. Iowa City: University of Iowa; 1976. Benton AL, Hamsher K. Multilingual aphasia examination. Iowa City: University of Iowa; 1976.
34.
go back to reference Delis DC, Kramer JH, Kaplan E, Ober BA. California Verbal Learning Test: adult version; manual. 2nd ed. San Antonio, TX: Psychological Corporation; 2000. Delis DC, Kramer JH, Kaplan E, Ober BA. California Verbal Learning Test: adult version; manual. 2nd ed. San Antonio, TX: Psychological Corporation; 2000.
35.
go back to reference Warrington EK, James M. The Visual Object and Space Perception Battery. Bury St. Edmunds, UK: Thames Valley; 1991. Warrington EK, James M. The Visual Object and Space Perception Battery. Bury St. Edmunds, UK: Thames Valley; 1991.
36.
go back to reference Posner MI, Petersen SE. The attention system of the human brain. Annu Rev Neurosci. 1990;13:25–42.CrossRefPubMed Posner MI, Petersen SE. The attention system of the human brain. Annu Rev Neurosci. 1990;13:25–42.CrossRefPubMed
41.
go back to reference Lai CK. The merits and problems of Neuropsychiatric Inventory as an assessment tool in people with dementia and other neurological disorders. Clin Interv Aging. 2014;9:1051–61.CrossRefPubMedPubMedCentral Lai CK. The merits and problems of Neuropsychiatric Inventory as an assessment tool in people with dementia and other neurological disorders. Clin Interv Aging. 2014;9:1051–61.CrossRefPubMedPubMedCentral
42.
go back to reference Nelson PT, Kryscio RJ, Jicha GA, Abner EL, Schmitt FA, Xu LO, et al. Relative preservation of MMSE scores in autopsy-proven dementia with Lewy bodies. Neurology. 2009;73:1127–33.CrossRefPubMedPubMedCentral Nelson PT, Kryscio RJ, Jicha GA, Abner EL, Schmitt FA, Xu LO, et al. Relative preservation of MMSE scores in autopsy-proven dementia with Lewy bodies. Neurology. 2009;73:1127–33.CrossRefPubMedPubMedCentral
43.
go back to reference Lessig S, Nie D, Xu R, Corey-Bloom J. Changes on brief cognitive instruments over time in Parkinson’s disease. Mov Disord. 2012;27:1125–8.CrossRefPubMed Lessig S, Nie D, Xu R, Corey-Bloom J. Changes on brief cognitive instruments over time in Parkinson’s disease. Mov Disord. 2012;27:1125–8.CrossRefPubMed
Metadata
Title
Apathy is associated with faster global cognitive decline and early nursing home admission in dementia with Lewy bodies
Authors
Monica H. Breitve
Kolbjørn Brønnick
Luiza J. Chwiszczuk
Minna J. Hynninen
Dag Aarsland
Arvid Rongve
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Alzheimer's Research & Therapy / Issue 1/2018
Electronic ISSN: 1758-9193
DOI
https://doi.org/10.1186/s13195-018-0416-5

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