Do people become more apathetic as they grow older? A longitudinal study in healthy individuals
ABSTRACT The aim of this study was to determine levels, rates and progression of apathy in healthy older persons and to investigate factors associated with its progression.
Seventy-six healthy elderly subjects, aged 58-85 years (mean 69.9), who were recruited by general advertisement and through local community groups, participated as a control group for a longitudinal study of stroke patients. Data were collected on demographic, psychological, neuropsychological and neuroimaging (MRI) variables and apathy was rated by informants on the Apathy Evaluation Scale (AES).
Apathy scores and rates increased over 5 years, especially in men. Change of apathy was associated with informant ratings of cognitive decline in the years prior to baseline assessment but not to subsequent neuropsychological, neuroimaging or functional changes.
Apathy increases with age in otherwise healthy community-dwelling individuals, particularly in men.
The American Sociologist 12/2014; 45(4):388-411. DOI:10.1007/s12108-014-9221-1
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ABSTRACT: Apathy is a common but poorly understood condition with a wide societal impact observed in several brain disorders as well as, to some extent, in the normal population. Hence the need for better characterization of the underlying mechanisms. The processes by which individuals decide to attribute physical effort to obtain rewards might be particularly relevant to relate to apathy traits. Here, we designed two paradigms to assess individual differences in physical effort production and effort-based decision-making and their relation to apathy in healthy people. Apathy scores were measured using a modified version of the Lille Apathy Rating Scale, suitable for use in a non-clinical population. In the first study, apathy scores were correlated with the degree to which stake (reward on offer) and difficulty level impacts on physical effort production. Individuals with relatively high apathy traits showed an increased modulation of effort while more motivated individuals generally exerted greater force across different levels of stake. To clarify the underlying mechanisms for this behavior, we designed a second task that allows independent titration of stake and effort levels for which subjects are willing to engage in an effortful response to obtain a reward. Our results suggest that apathy traits in the normal population are related to the way reward subjectively affects the estimation of effort costs, and more particularly manifest as decreased willingness to exert effort when rewards are small, or below threshold. The tasks we introduce here may provide useful tools to further investigate apathy in clinical populations.Journal of Physiology-Paris 04/2014; DOI:10.1016/j.jphysparis.2014.04.002 · 2.35 Impact Factor
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ABSTRACT: Objectives To determine the prevalence, incidence, persistence, likely causes and consequences of apathy in patients with type 2 diabetes and to compare the prevalence with a healthy control sample. Design Cross-sectional comparison of diabetic and nondiabetic samples; longitudinal follow-up of diabetic sample. Setting Academic research department. Participants Non-demented, older patients with long-standing type 2 diabetes (n=122) recruited from a community-based cohort study and 69 healthy volunteers. Measurements Clinical assessments of apathy and potential causative conditions, repeated in the diabetic sample after 16.7±2.5 months. Informant rated symptoms from the 14-item Apathy Scale were used to generate apathy diagnoses based on standardised criteria. Cognition was assessed by Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). Results The diabetic and comparison samples had the same age and MMSE scores, but the diabetic sample had a higher frequency of depression, cerebrovascular history and cognitive deficits. Apathy was more prevalent in diabetes (diabetic vs control sample: 13.9 vs 1.4%, P=0.005) and was independently associated with CDR 0.5 status (odds ratio (95% CI): 3.66 (1.25-19.70)) and depression (8.48 (2.74-26.21)). In 108 diabetic patients who were followed up, incident apathy occurred in 7.4% of cases, and persisted in 50% of those with baseline apathy. Baseline apathy was independently associated with lnHbA1c levels (Beta 0.20, t=2.29, df=119, P=0.024; Model R2=0.10) and incident/persistent apathy was associated with greater risk of cognitive decline (6.72 (1.19-37.87)). Conclusions Apathy is a frequent neuropsychiatric syndrome in older patients with type 2 diabetes, and is associated with poor glycaemic control and cognitive decline.American Journal of Geriatric Psychiatry 10/2014; DOI:10.1016/j.jagp.2014.09.010 · 3.52 Impact Factor