OBJECTIVE: Apathy is a common feature of Parkinson's disease (PD) that can manifest independently of depression, but little is known about its natural progression in medically managed patients. The present study sought to characterize and compare trajectories of apathy, depression, and motor symptoms in PD over 18 months. METHOD: Data from a sample of 186 PD patients (mean disease duration of 8.2 years) followed by the University of Florida Movement Disorders Center were obtained from a clinical research database. Scores on the Unified Parkinson's disease Rating Scale (motor portion), Apathy Scale, and Beck Depression Inventory at three time-points (baseline, 6 months, 18 months) were analyzed in a structural equation modeling framework. RESULTS: A multivariate growth model controlling for age, sex, education, and disease duration identified linear worsening of both apathy (slope estimate = 0.73; p < .001) and motor symptoms (slope estimate = 1.51; p < .001), and quadratic changes in depression (slope estimate = 1.18; p = .07). All symptoms were positively correlated. Higher education was associated with lower apathy, depression, and motor severity. Advanced age was associated with greater motor and apathy severity. Female sex and longer disease duration were associated with attenuated motor worsening. Antidepressant use was associated only with depression scores. CONCLUSIONS: These longitudinal results support the differentiation of apathy and depression in PD. Like motor progression, apathy progression may be linked at least partially to dopaminergic neurodegeneration. Empirically supported treatments for apathy in PD are needed.
OBJECTIVE: Apathy is a common feature of Parkinson's disease (PD) that can manifest independently of depression, but little is known about its natural progression in medically managed patients. The present study sought to characterize and compare trajectories of apathy, depression, and motor symptoms in PD over 18 months. METHOD: Data from a sample of 186 PDpatients (mean disease duration of 8.2 years) followed by the University of Florida Movement Disorders Center were obtained from a clinical research database. Scores on the Unified Parkinson's disease Rating Scale (motor portion), Apathy Scale, and Beck Depression Inventory at three time-points (baseline, 6 months, 18 months) were analyzed in a structural equation modeling framework. RESULTS: A multivariate growth model controlling for age, sex, education, and disease duration identified linear worsening of both apathy (slope estimate = 0.73; p < .001) and motor symptoms (slope estimate = 1.51; p < .001), and quadratic changes in depression (slope estimate = 1.18; p = .07). All symptoms were positively correlated. Higher education was associated with lower apathy, depression, and motor severity. Advanced age was associated with greater motor and apathy severity. Female sex and longer disease duration were associated with attenuated motor worsening. Antidepressant use was associated only with depression scores. CONCLUSIONS: These longitudinal results support the differentiation of apathy and depression in PD. Like motor progression, apathy progression may be linked at least partially to dopaminergic neurodegeneration. Empirically supported treatments for apathy in PD are needed.
Authors: Martine Visser; Albert F G Leentjens; Johan Marinus; Anne M Stiggelbout; Jacobus J van Hilten Journal: Mov Disord Date: 2006-05 Impact factor: 10.338
Authors: Stephanie Cosentino; Laura B Zahodne; Jason Brandt; Deborah Blacker; Marilyn Albert; Bruno Dubois; Yaakov Stern Journal: Alzheimers Dement Date: 2014-03-18 Impact factor: 21.566
Authors: Miriam E Shapiro; Jeannette R Mahoney; Barry S Zingman; David L Pogge; Joe Verghese Journal: J Clin Exp Neuropsychol Date: 2013-10-04 Impact factor: 2.475
Authors: Laura B Zahodne; Katherine Ornstein; Stephanie Cosentino; D P Devanand; Yaakov Stern Journal: Am J Geriatr Psychiatry Date: 2013-07-17 Impact factor: 4.105
Authors: Jacob D Jones; Paul Mangal; Jacob Lafo; Michael S Okun; Dawn Bowers Journal: J Neuropsychiatry Clin Neurosci Date: 2016-01-21 Impact factor: 2.198
Authors: Aron Baumann; Carlos G Moreira; Marta M Morawska; Sophie Masneuf; Christian R Baumann; Daniela Noain Journal: Front Hum Neurosci Date: 2016-11-18 Impact factor: 3.169
Authors: Robert A Hauser; Dean Sutherland; Juan A Madrid; Maria Angeles Rol; Steven Frucht; Stuart Isaacson; Fernando Pagan; Brian N Maddux; George Li; Winona Tse; Benjamin L Walter; Rajeev Kumar; Daniel Kremens; Mark F Lew; Aaron Ellenbogen; Odinachi Oguh; Alberto Vasquez; William Kinney; Matt Lowery; Maria Resnick; Nicole Huff; Jerry Posner; Karla V Ballman; Brian E Harvey; Michael Camilleri; Michael Zasloff; Denise Barbut Journal: Clin Park Relat Disord Date: 2019-07-02