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Clinical and demographic correlates of apathy in Parkinson’s disease

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Abstract

Objective

To better understand the demographic, neuropsychiatric, cognitive, and motor predictors of apathy in Parkinson’s disease (PD).

Method

112 participants (Mage = 68.53 years; Mdisease duration = 6.17 years) were administered the Apathy Scale (AS), Beck Depression Inventory-II (BDI-II), Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Trail Making Test (TMT), Wechsler Adult Intelligence Scale-IV Matrix Reasoning subtest, letter (F-A-S) and category (Animals) fluency, and Hopkins Verbal Learning Test-Revised. Psychosis was assessed. A stepwise logistic regression analysis was performed to investigate the ability of demographic factors and clinical assessments to predict nonapathetic (AS ≤ 13) versus apathetic (AS > 13) group membership.

Results

The regression analysis yielded a robust model in which older age, less education, elevated BDI-II, current psychosis, higher MDS-UPDRS Part III (motor score), and slower TMT-B performance predicted membership in the apathetic group, with a correct classification rate of 77.5% (Nagelkerke R2 = 0.48, p < .001). Depression (OR = 9.20, p < .001) and education (OR = 0.66, p = 0.002) contributed significantly to the overall model. A linear regression with AS score as the outcome variable was similar, but TMT-B additionally contributed significantly (p = 0.02) to the overall model, F(6, 86) = 12.02, p < .001, adjusted R2 = 0.42.

Conclusions

Of the factors examined, depression, education, and executive functioning were the strongest correlates of apathy in PD. These results support the idea that common underlying frontosubcortical disruptions in this population contribute to apathy, depression, and executive dysfunction.

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Acknowledgements

This study was funded by the American Parkinson Disease Association Center for Advanced Research at the University of Virginia.

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Authors and Affiliations

  1. Department of Neurology, University of Virginia, PO Box 800394, 22908-0394, Charlottesville, VA, USA

    Daniel S. Brown, Matthew J. Barrett, Joseph L. Flanigan & Scott A. Sperling

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  1. Daniel S. Brown
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  2. Matthew J. Barrett
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  4. Scott A. Sperling
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Correspondence to Scott A. Sperling.

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The authors declare that they have no conflict of interest.

Ethical standards

This study received local institutional review board approval and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Written informed consent was obtained from all participants prior to their inclusion in the study.

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Brown, D.S., Barrett, M.J., Flanigan, J.L. et al. Clinical and demographic correlates of apathy in Parkinson’s disease. J Neurol 266, 507–514 (2019). https://doi.org/10.1007/s00415-018-9166-3

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  • DOI: https://doi.org/10.1007/s00415-018-9166-3

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