Keera N Fishman1,2, Andrea R Ashbaugh1, Krista L Lanctôt2, Megan L Cayley3, Nathan Herrmann4, Brian J Murray3, Michelle Sicard5, Karen Lien5, Demetrios J Sahlas6, Richard H Swartz3. 1. School of Psychology, Faculty of Social Sciences, University of Ottawa, Jean Jacques Lussier, VNR, Ottawa, Ontario, K1N 6N5, Canada. 2. Department of Medicine (Psychiatry), Sunnybrook Health Sciences Centre, Bayview Avenue, Room FG21, Toronto, Ontario, M4N 3M5, Canada. 3. Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada. 4. Department of Medicine (Psychiatry), Sunnybrook Health Sciences Centre, Room FG19, Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada. 5. Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Toronto, Ontario, M4N 3M5, Canada. 6. Department of Medicine (Neurology), McMaster University, Hamilton, Ontario, Canada.
Abstract
OBJECTIVE: Psychiatric symptoms, including depression and apathy, may significantly impede functional and cognitive capabilities following a cerebrovascular event. This study examined the role of apathy and depression on learning and memory performance in stroke patients. METHOD: Stroke patients (n = 140 [119 ischemic, 21 hemorrhagic], mean age = 60.6 [SD = 15.1]) completed the Apathy Evaluation Scale (AES), the Center for Epidemiologic Studies Depression Scale (CES-D), and the California Verbal Learning Test-Second Edition (CVLT-II). RESULTS: Using a 2 × 2 MANOVA with depression (CESD ≥ 16) and apathy (AES ≥ 34) as the independent variables and cognitive performance (i.e., verbal acquisition, short-term free recall, and long-term free recall) as the dependent variables, we found a main effect for apathy (F[3,134] = 2.98, p = .034), such that apathetic stroke patients (n = 24) performed significantly worse on verbal acquisition (F[1,136] = 6.44; p = .012), short-term free recall (F[1,136] = 7.86; p = .006), and long-term free recall (F[1,136] = 8.37; p = .004) than nonapathetic stroke patients (n = 116). There was no main effect of depression on cognitive performance (F[1,136] = 1.72, p = .155). CONCLUSIONS: These results suggest that apathy, not depression, is related to verbal memory performance in stroke patients. Future research should explore whether treatment of apathy (e.g., improving motivation) could be a novel target for improving cognition after stroke. Researchers should also examine whether this model can be applied to other aspects of cognition, including executive function and other areas of memory including autobiographical and working memory.
OBJECTIVE: Psychiatric symptoms, including depression and apathy, may significantly impede functional and cognitive capabilities following a cerebrovascular event. This study examined the role of apathy and depression on learning and memory performance in strokepatients. METHOD:Strokepatients (n = 140 [119 ischemic, 21 hemorrhagic], mean age = 60.6 [SD = 15.1]) completed the Apathy Evaluation Scale (AES), the Center for Epidemiologic Studies Depression Scale (CES-D), and the California Verbal Learning Test-Second Edition (CVLT-II). RESULTS: Using a 2 × 2 MANOVA with depression (CESD ≥ 16) and apathy (AES ≥ 34) as the independent variables and cognitive performance (i.e., verbal acquisition, short-term free recall, and long-term free recall) as the dependent variables, we found a main effect for apathy (F[3,134] = 2.98, p = .034), such that apathetic strokepatients (n = 24) performed significantly worse on verbal acquisition (F[1,136] = 6.44; p = .012), short-term free recall (F[1,136] = 7.86; p = .006), and long-term free recall (F[1,136] = 8.37; p = .004) than nonapathetic strokepatients (n = 116). There was no main effect of depression on cognitive performance (F[1,136] = 1.72, p = .155). CONCLUSIONS: These results suggest that apathy, not depression, is related to verbal memory performance in strokepatients. Future research should explore whether treatment of apathy (e.g., improving motivation) could be a novel target for improving cognition after stroke. Researchers should also examine whether this model can be applied to other aspects of cognition, including executive function and other areas of memory including autobiographical and working memory.