Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan;26(1):100-106.
doi: 10.1016/j.jagp.2017.06.012. Epub 2017 Jun 16.

Apathy Mediates Cognitive Difficulties in Geriatric Depression

Cynthia M Funes  1 , Helen Lavretsky  2 , Linda Ercoli  1 , Natalie St Cyr  1 , Prabha Siddarth  1
Affiliations

Apathy Mediates Cognitive Difficulties in Geriatric Depression

Cynthia M Funes et al. Am J Geriatr Psychiatry. 2018 Jan.

Abstract

Objective: Cognitive impairment associated with late-life depression can persist after remission of mood symptoms. Apathy, a common symptom of late-life depression, often leads to worse clinical outcomes. We examined if severity of apathy mediates cognitive difficulties in a cohort of older adults with major depression.

Methods: One hundred thirty-eight older adults with depression (54.4% female; mean [SD] age: 69.7 [7.4] years; mean [SD] education:15.6 [2.7] years) were recruited to participate in a treatment study, and only baseline data were analyzed. All participants received a comprehensive evaluation of depression, apathy, and cognition. We examined whether apathy mediated the relationship between depression and cognition, focusing our attention on memory and cognitive control. We then explored whether the mediation effects differed across women and men.

Results: Increased apathy was significantly associated with worse depression and lower performance in the cognitive control domain but not in memory. Higher depressive scores were significantly associated with worse cognitive control but not memory. Mediation analyses revealed a significant indirect effect on cognitive control by depression through increased apathy scores with the mediator accounting for 21% of the total effect. Stratifying by sex, we found that women exhibited a significant indirect effect, with the mediator accounting for 47% of the total effect, whereas there was no mediation by apathy in men.

Conclusions: The findings imply that increased apathy mediates the relationship between cognition and depression. The identification of mediating effects may inform future treatment strategies and preventive interventions that can focus on decreasing apathy to improve cognition in late-life depression.

Keywords: Apathy; cognition; late life depression; sex differences.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mediation Model. The a-path represents the association between depression (HDRS-24) scores and apathy. The b-path denotes the relationship between apathy and cognitive scores, while also controlling for depression. The c-path and the c’-path represent the associations between HDRS-24 and cognitive scores without and with apathy included as a mediator, respectively. Age, sex, educational level used as covariates in all analyses.
See this image and copyright information in PMC

References

    1. Sheline YI, Barch DM, Garcia K, et al. Cognitive Function in Late Life Depression: Relationships to Depression Severity, Cerebrovascular Risk Factors and Processing Speed. Biol Psychiatry. 2006;60(1):58–65. doi: 10.1016/j.biopsych.2005.09.019. - DOI - PubMed
    1. Morimoto SS, Kanellopoulos D, Manning KJ, Alexopoulos GS. Diagnosis and treatment of depression and cognitive impairment in late life. Ann N Y Acad Sci. 2015;1345(1):36–46. doi: 10.1111/nyas.12669. - DOI - PMC - PubMed
    1. Lehrner J, Moser D, Klug S, et al. Subjective memory complaints, depressive symptoms and cognition in Parkinson’s disease patients. Eur J Neurol. 2014;21(10):1276–1e77. doi: 10.1111/ene.12470. - DOI - PubMed
    1. Gotlib IH, Joormann J. Cognition and depression: Current status and future directions. Annu Rev Clin Psychol. 2010;6:285–312. doi: 10.1146/annurev.clinpsy.121208.131305. - DOI - PMC - PubMed
    1. Gill TM, Richardson ED, Tinetti ME. Evaluating the risk of dependence in activities of daily living among community-living older adults with mild to moderate cognitive impairment. [Accessed February 21, 2017];J Gerontol A Biol Sci Med Sci. 1995 50(5):M235-41. http://www.ncbi.nlm.nih.gov/pubmed/7671024. - PubMed

Publication types