Apathy, but not depression, is associated with executive dysfunction in cerebral small vessel disease.
Morris, Robin G
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Lohner, V., Brookes, R., Hollocks, M., Morris, R. G., & Markus, H. (2017). Apathy, but not depression, is associated with executive dysfunction in cerebral small vessel disease.. PLoS One, 12 (5. e0176943)https://doi.org/10.1371/journal.pone.0176943
OBJECTIVE: To determine the prevalence of apathy and depression in cerebral small vessel disease (SVD), and the relationships between both apathy and depression with cognition. To examine whether apathy is specifically related to impairment in executive functioning and processing speed. METHODS: 196 patients with a clinical lacunar stroke and an anatomically corresponding lacunar infarct on MRI were compared to 300 stroke-free controls. Apathy and depression were measured using the Geriatric Depression Scale, and cognitive functioning was assessed using an SVD cognitive screening tool, the Brief Memory and Executive Test, which measures executive functioning/processing speed and memory/orientation. Path analysis and binary logistic regression were used to assess the relation between apathy, depression and cognitive impairment. RESULTS: 31 participants with SVD (15.8%) met criteria for apathy only, 23 (11.8%) for both apathy and depression, and 2 (1.0%) for depression only. In the SVD group the presence of apathy was related to global cognition, and specifically to impaired executive functioning/processing speed, but not memory/orientation. The presence of depression was not related to global cognition, impaired executive functioning/processing speed or memory/orientation. CONCLUSIONS: Apathy is a common feature of SVD and is associated with impaired executive functioning/processing speed suggesting the two may share biological mechanisms. Screening for apathy should be considered in SVD, and further work is required to develop and evaluate effective apathy treatment or management in SVD.
Aged, Apathy, Cerebral Small Vessel Diseases, Cognition, Cognitive Dysfunction, Depression, Executive Function, Female, Humans, Male, Middle Aged
This work was supported by a Priority Program Grant from the Stroke Association (TSA PPA 2015-02; www.stroke.org.uk). The BMET Study was supported by a grant from the Stroke Association (TSA2008/10). Valerie Lohner is supported by a Stroke Association/British Heart Foundation Program Grant (TSA BHF 2010/01; www.bhf.org.uk). Rebecca Brookes is supported by a BHF Project Grant (PG/13/30/30005). Recruitment to the BMET Study was supported by the English National Institute of Health Research (NIHR) Clinical Stroke Research Network (www.crn.nihr.ac.uk/stroke). Hugh Markus is supported by an NIHR Senior Investigator award (www.nihr.ac.uk) and his work is supported by the Cambridge University Hospital Comprehensive NIHR Biomedical Research Unit (www.cambridge-brc.org.uk).
Stroke Association (TSA BHF 2010/01)
British Heart Foundation (PG/13/30/30005)
External DOI: https://doi.org/10.1371/journal.pone.0176943
This record's URL: https://www.repository.cam.ac.uk/handle/1810/274067
Attribution 4.0 International
Licence URL: http://creativecommons.org/licenses/by/4.0/
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