Ratko Radakovic1,2,3,4,5, Richard Davenport2, John M Starr3,5, Sharon Abrahams1,2,4,5. 1. Human Cognitive Neuroscience, University of Edinburgh, Edinburgh, UK. 2. Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK. 3. Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK. 4. Euan MacDonald Centre for MND Research, University of Edinburgh, Edinburgh, UK. 5. Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK.
Abstract
OBJECTIVE: Apathy is a prominent and disabling symptom in Parkinson's disease (PD) and is a multidimensional behaviour, but which dimensions are specifically affected is unclear. Therefore, the aim of this preliminary study was to determine the psychometric properties of the Dimensional Apathy Scale (DAS) and explore the multidimensional profile of apathy in PD patients. METHODS: Thirty-four PD patients, with 30 of their informants/carers, and 34 healthy controls, with 30 of their informants, completed the DAS, Apathy Evaluation Scale and the Geriatric Depression Scale Short Form. Motor staging and independent living status were recorded. RESULTS: Comparative group analyses revealed that PD patients were significantly more apathetic on self-rated executive (p = 0.01) and initiation (p = 0.03) dimensions than controls, where only executive apathy was significantly higher in ratings of patients' informants/carers compared with controls' informants (p = 0.02). A third of patients were impaired on at least one apathy dimension. Additionally, patients with apathy tended to have more impaired activities of daily living, while none of the apathy dimensions related to motor disability. CONCLUSION: Our findings show the DAS is a valid and reliable multidimensional apathy tool for use in PD. PD is characterised by an executive apathy profile as determined by informants/carers, although patients described both executive and initiation apathy. This indicates a lack of motivation for planning, organisation and attention and lack of initiation of thoughts or behaviours. Further research is needed to determine the cognitive underpinnings of this emerging apathy profile and the clinical impact in PD.
OBJECTIVE: Apathy is a prominent and disabling symptom in Parkinson's disease (PD) and is a multidimensional behaviour, but which dimensions are specifically affected is unclear. Therefore, the aim of this preliminary study was to determine the psychometric properties of the Dimensional Apathy Scale (DAS) and explore the multidimensional profile of apathy in PD patients. METHODS: Thirty-four PD patients, with 30 of their informants/carers, and 34 healthy controls, with 30 of their informants, completed the DAS, Apathy Evaluation Scale and the Geriatric Depression Scale Short Form. Motor staging and independent living status were recorded. RESULTS: Comparative group analyses revealed that PD patients were significantly more apathetic on self-rated executive (p = 0.01) and initiation (p = 0.03) dimensions than controls, where only executive apathy was significantly higher in ratings of patients' informants/carers compared with controls' informants (p = 0.02). A third of patients were impaired on at least one apathy dimension. Additionally, patients with apathy tended to have more impaired activities of daily living, while none of the apathy dimensions related to motor disability. CONCLUSION: Our findings show the DAS is a valid and reliable multidimensional apathy tool for use in PD. PD is characterised by an executive apathy profile as determined by informants/carers, although patients described both executive and initiation apathy. This indicates a lack of motivation for planning, organisation and attention and lack of initiation of thoughts or behaviours. Further research is needed to determine the cognitive underpinnings of this emerging apathy profile and the clinical impact in PD.
Authors: Hillary D Lum; Sarah R Jordan; Adreanne Brungardt; Roman Ayele; Maya Katz; Janis M Miyasaki; Anne Hall; Jacqueline Jones; Benzi Kluger Journal: Neurology Date: 2019-04-26 Impact factor: 9.910
Authors: Franziska Maier; Annika Spottke; Jan-Philipp Bach; Claudia Bartels; Katharina Buerger; Richard Dodel; Andreas Fellgiebel; Klaus Fliessbach; Lutz Frölich; Lucrezia Hausner; Martin Hellmich; Stefan Klöppel; Arne Klostermann; Johannes Kornhuber; Christoph Laske; Oliver Peters; Josef Priller; Tanja Richter-Schmidinger; Anja Schneider; Kija Shah-Hosseini; Stefan Teipel; Christine A F von Arnim; Jens Wiltfang; Frank Jessen Journal: JAMA Netw Open Date: 2020-05-01