10.17863/CAM.53175
Tay, Jonathan
0000-0003-0598-0004
Morris, Robin G
Tuladhar, Anil M
0000-0002-4815-2834
Husain, Masud
de Leeuw, Frank-Erik
Markus, Hugh S
Apathy, but not depression, predicts all-cause dementia in cerebral small vessel disease.
BMJ
2020
Aged
Apathy
Cerebral Small Vessel Diseases
Dementia
Depression
Female
Humans
Male
Predictive Value of Tests
Prodromal Symptoms
Prospective Studies
Apollo - University of Cambridge Repository
University of Cambridge
013meh722
2020-06-03
2020-06-03
2020-09
eng
Article
https://www.repository.cam.ac.uk/handle/1810/306096
10.1136/jnnp-2020-323092
All rights reserved
open.access
OBJECTIVE: To determine whether apathy or depression predicts all-cause dementia in small vessel disease (SVD) patients. METHODS: Analyses used two prospective cohort studies of SVD: St. George's Cognition and Neuroimaging in Stroke (SCANS; n=121) and Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC; n=352). Multivariate Cox regressions were used to predict dementia using baseline apathy and depression scores in both datasets. Change in apathy and depression was used to predict dementia in a subset of 104 participants with longitudinal data from SCANS. All models were controlled for age, education and cognitive function. RESULTS: Baseline apathy scores predicted dementia in SCANS (HR 1.49, 95% CI 1.05 to 2.11, p=0.024) and RUN DMC (HR 1.05, 95% CI 1.01 to 1.09, p=0.007). Increasing apathy was associated with dementia in SCANS (HR 1.53, 95% CI 1.08 to 2.17, p=0.017). In contrast, baseline depression and change in depression did not predict dementia in either dataset. Including apathy in predictive models of dementia improved model fit. CONCLUSIONS: Apathy, but not depression, may be a prodromal symptom of dementia in SVD, and may be useful in identifying at-risk individuals.
Stroke Association
PPA 2015/02