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. 2020 Dec 10;8(1):92-99.
doi: 10.1002/mdc3.13127. eCollection 2021 Jan.

Delineation of Apathy Subgroups in Parkinson's Disease: Differences in Clinical Presentation, Functional Ability, Health-related Quality of Life, and Caregiver Burden

Graham M L Eglit  1   2 , Francesca Lopez  3 , Dawn M Schiehser  3   1 , Eva Pirogovsky-Turk  1 , Irene Litvan  4 , Stephanie Lessig  1   4 , J Vincent Filoteo  1   3   4
Affiliations

Delineation of Apathy Subgroups in Parkinson's Disease: Differences in Clinical Presentation, Functional Ability, Health-related Quality of Life, and Caregiver Burden

Graham M L Eglit et al. Mov Disord Clin Pract. .

Abstract

Background: Apathy is a prevalent, multidimensional neuropsychiatric condition in Parkinson's disease (PD). Several authors have proposed apathy subtypes in PD, but no study has examined the classification of PD patients into distinct apathy subtypes, nor has any study examined the clinical utility of doing so.

Objectives: The current study used a data-driven approach to explore the existence and associated clinical characteristics of apathy subtypes in PD.

Method: The Apathy Scale (AS) was administered to 157 non-demented individuals with PD. Participants were classified into apathy subgroups through cluster analysis. Differences among apathy subtypes on external clinical indicators were explored across apathy subgroups.

Results: Individuals with PD were classified into three subgroups: a Non-Apathetic group with low levels of apathy symptoms, a Low Interest/Energy group, characterized by elevated symptoms of low interest/energy and minimal low initiation/emotional indifference symptoms, and a Low Initiation group, characterized by an absence of low interest/energy symptoms and elevated levels of low initiation/emotional indifference symptoms. Both Low Interest/Energy and Low Initiation groups exhibited worse depression, fatigue, anxiety, health-related quality of life, and caregiver burden than the Non-Apathetic subgroup. The Low Initiation group exhibited worse overall cognition, emotional well-being, state anxiety, communicative ability, and functional ability than the Low Interest/Energy group. Importantly, disease-related characteristics did not differ across apathy symptom subgroups.

Conclusions: Non-demented PD patients can be separated into distinct apathy symptom subgroups, which are differentially associated with important clinical variables. Apathy subgroup membership may reflect disruption to different neural systems independent of disease progression.

Keywords: apathy subgroups; clinical correlates; cluster analysis; Parkinson's disease.

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Conflict of interest statement

This project was funded by VA Merit Award grants to Dawn Schiehser (1I01RX001691‐01A1) and J. Vincent Filoteo (5I01CX000813–04). The authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Z score mean and standard error plot of non‐apathetic (n = 48), low interest/energy (n = 76), and low initiation (n = 33) groups
See this image and copyright information in PMC

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