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. 2018 Aug 18;10(1):83.
doi: 10.1186/s13195-018-0416-5.

Apathy is associated with faster global cognitive decline and early nursing home admission in dementia with Lewy bodies

Monica H Breitve  1   2   3 , Kolbjørn Brønnick  4   5 , Luiza J Chwiszczuk  6   7   8 , Minna J Hynninen  9   10 , Dag Aarsland  11   12 , Arvid Rongve  6   7   8
Affiliations

Apathy is associated with faster global cognitive decline and early nursing home admission in dementia with Lewy bodies

Monica H Breitve et al. Alzheimers Res Ther. .

Abstract

Background: Little is known about the consequences of apathy in dementia with Lewy bodies (DLB), because previous research on apathy in dementia focused mainly on Alzheimer's disease (AD).

Methods: In this longitudinal study, we included patients with AD (n = 128) and patients with DLB (n = 81). At baseline, we analyzed the associations between apathy and cognition in the total sample and in AD and DLB separately. Generalized linear mixed models were used to investigate the association between apathy and Mini Mental State Examination (MMSE) over 4 years, and the Kaplan-Meier method was used to assess the association between apathy and survival or nursing home admission.

Results: In patients with DLB, apathy was associated with a faster global cognitive decline (MMSE) over 4 years. Patients with DLB and apathy had shorter time until nursing home admission than DLB patients without apathy and patients with AD, regardless of apathy. At baseline, patients with apathy had decreased performance on the Stroop color test and a composite executive function score. Neurocognition was unaffected by apathy in AD, but DLB patients with apathy had more verbal learning difficulties.

Conclusions: Apathy seems to be associated with more serious symptomatology in DLB than in AD. It is important to focus on apathy in dementia because it is one of the most prevalent and disturbing behavioral and psychological symptoms.

Keywords: Alzheimer’s disease; Apathy; Dementia; Dementia with Lewy bodies; Longitudinal; Neuropsychology; Survival.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Regional Committee for Medical and Health Research Ethics in Western Norway (REK) and the Norwegian Social Science Data Services (REK number 167.04). Patients gave written consent to participate.

Competing interests

DA has received research support and/or honoraria from AstraZeneca, H. Lundbeck, Novartis Pharmaceuticals, and GE Health and has served as a paid consultant for H. Lundbeck, Eisai, and Evonik. DA is also a Royal Society Wolfson Research Merit Award holder. This study represents independent research partly funded by the National Institute for Health Research (NIHR) Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Study flowchart. AD Alzheimer’s disease, DLB Dementia with Lewy bodies, FTD Frontotemporal dementia, MCI Mild cognitive impairment, VaD Vascular dementia, PDD Parkinson’s disease dementia, DEMVEST Dementia Study of Western Norway
Fig. 2
Fig. 2
Time until nursing home admission. AD Alzheimer’s disease, DLB Dementia with Lewy bodies
See this image and copyright information in PMC

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