Persistent apathy in Alzheimer's disease as an independent factor of rapid functional decline: the REAL longitudinal cohort study
✍ Scribed by L. Lechowski; M. Benoit; P. Chassagne; I. Vedel; D. Tortrat; L. Teillet; B. Vellas
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 80 KB
- Volume
- 24
- Category
- Article
- ISSN
- 0885-6230
- DOI
- 10.1002/gps.2125
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✦ Synopsis
Abstract
Objective
To determine the role of persistent apathy in rapid loss of autonomy in Instrumental Activities of Daily Living (IADL) in women with Alzheimer´s disease (AD), taking into account the grade of cognitive decline.
Methods
The study was conducted on 272 women from the French REAL cohort. At inclusion patients had a Mini‐Mental State Examination (MMSE) score between 10–26. A rapid functional decline was defined as a yearly drop of 4 points or more on the 14‐point IADL Lawton scale. Persistent apathy was defined as a frequency score equal to 3 or 4 on the Neuro‐Psychiatric Inventory at the three consecutive 6‐monthly assessments.
Results
27.6% of women had rapid functional decline in 1 year and 22.1% of them had persistent apathy. A logistic regression analysis showed that, in addition to cognitive decline, persistent apathy plays a role in rapid functional decline in 1 year. For example, for a 3‐point decline in MMSE in 1 year, the probability of a rapid loss in IADL is 0.45 for women with persistent apathy compared with 0.28 for those without persistent apathy.
Conlusions
In this study, a rapid loss in IADL score was partly explained by persistent apathy. Copyright © 2008 John Wiley & Sons, Ltd.