Apathy, but not depression, predicts all-cause dementia in cerebral small vessel disease.
Morris, Robin G
de Leeuw, Frank-Erik
Journal of neurology, neurosurgery, and psychiatry
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Tay, J., Morris, R. G., Tuladhar, A. M., Husain, M., de Leeuw, F., & Markus, H. (2020). Apathy, but not depression, predicts all-cause dementia in cerebral small vessel disease.. Journal of neurology, neurosurgery, and psychiatry, 91 (9), 953-959. https://doi.org/10.1136/jnnp-2020-323092
Objective: To determine whether apathy or depression predicts all-cause dementia in small vessel disease (SVD) patients. Methods: Analyses used two prospective cohort studies of SVD: St. George's Cognition and Neuroimaging in Stroke (SCANS; n=121) and Radboud University Nijmegen Diffusion tensor and Magnetic resonance Cohort (RUN DMC; n=352). Multivariate Cox regressions were used to predict dementia using baseline apathy and depression scores in both datasets. Change in apathy and depression was used to predict dementia in a subset of 104 participants with longitudinal data from SCANS. All models were controlled for age, education, and cognitive function. Results: Baseline apathy scores predicted dementia in SCANS (HR=1.49, 95% CI=1.05-2.11, P=0.024), and RUN DMC (HR=1.05, 95% CI=1.01-1.09, P=0.007). Increasing apathy was associated with dementia in SCANS (HR=1.53, 95% CI=1.08-2.17, P=0.017). In contrast, baseline depression and change in depression did not predict dementia in either dataset. Including apathy in predictive models of dementia improved model fit. Conclusions: Apathy, but not depression, may be a prodromal symptom of dementia in SVD, and may be useful in identifying at-risk individuals.
Humans, Dementia, Prospective Studies, Predictive Value of Tests, Depression, Aged, Female, Male, Apathy, Cerebral Small Vessel Diseases, Prodromal Symptoms
Stroke Association (PPA 2015/02)
External DOI: https://doi.org/10.1136/jnnp-2020-323092
This record's URL: https://www.repository.cam.ac.uk/handle/1810/306096
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