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Assessment of apathy minimising the effect of motor dysfunctions in Parkinson’s disease: a validation study of the dimensional apathy scale

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Abstract

Purpose

Apathy is associated with motor symptoms in Parkinson’s disease (PD); therefore, its evaluation could be influenced by motor disability. The Dimensional Apathy Scale (DAS) evaluates apathy excluding confounding effects of motor symptoms. The present study had three major aims: (a) to explore the psychometric properties of the DAS in non-demented PD patients; (b) to determine an optimal cut-off score of the DAS to identify apathetic PD patients; and (c) to determine a specific apathy profile in PD patients as compared to healthy controls (HC).

Methods

One hundred and seven PD patients and 100 HC completed the DAS. To explore convergent and divergent validity of the DAS in PD, patients underwent the Apathy Evaluation Scale and tools for assessing depressive symptoms, anxiety and cognition. Clinical aspects were recorded. Receiver operating characteristic curve analyses were carried out to estimate the optimal cut-off score to identify clinically significant apathy.

Results

The DAS scores showed high internal consistency and good evidence for convergent and discriminant validity. Maximum discrimination between apathetic and non-apathetic patients was obtained with a cut-off score of 28.5 (total score range: 0–72 with higher score indicating more severe apathy). Comparison between PD and HC groups revealed significant differences on total DAS, behavioural/cognitive initiation and emotional subscales.

Conclusions

The DAS is a valid and reliable tool to assess multidimensional apathy in PD, independently of severity of motor symptoms. Reduced initiation of thought and behaviour and emotional blunting characterised PD patients, without confounding effects of motor disability.

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Authors and Affiliations

  1. Department of Psychology, University of Campania Luigi Vanvitelli, Viale Ellittico 31, 81100, Caserta, Italy

    Gabriella Santangelo, Alfonsina D’Iorio, Fausta Piscopo, Sofia Cuoco & Chiara Baiano

  2. Institute of Diagnosis and Care (IDC), Hermitage-Capodimonte, Naples, Italy

    Gabriella Santangelo, Katia Longo, Marianna Amboni & Carmine Vitale

  3. Department of Medicine, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Fisciano, Italy

    Sofia Cuoco, Marianna Amboni, Maria Teresa Pellecchia & Paolo Barone

  4. Department of Motor Sciences and Wellness, University “Parthenope”, Naples, Italy

    Domenico Tafuri & Carmine Vitale

Authors
  1. Gabriella Santangelo
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  2. Alfonsina D’Iorio
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  3. Fausta Piscopo
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  4. Sofia Cuoco
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  7. Chiara Baiano
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  10. Paolo Barone
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  11. Carmine Vitale
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Correspondence to Gabriella Santangelo.

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Informed consent was obtained from all individual participants included in the study.

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“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.”

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Santangelo, G., D’Iorio, A., Piscopo, F. et al. Assessment of apathy minimising the effect of motor dysfunctions in Parkinson’s disease: a validation study of the dimensional apathy scale. Qual Life Res 26, 2533–2540 (2017). https://doi.org/10.1007/s11136-017-1569-6

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  • DOI: https://doi.org/10.1007/s11136-017-1569-6

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