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. 2021 Jan 28:12:620762.
doi: 10.3389/fnagi.2020.620762. eCollection 2020.

Evolution of Apathy in Early Parkinson's Disease: A 4-Years Prospective Cohort Study

Ruwei Ou  1 , Junyu Lin  1 , Kuncheng Liu  1 , Zheng Jiang  1 , Qianqian Wei  1 , Yanbing Hou  1 , Lingyu Zhang  1 , Bei Cao  1 , Bi Zhao  1 , Wei Song  1 , Huifang Shang  1
Affiliations

Evolution of Apathy in Early Parkinson's Disease: A 4-Years Prospective Cohort Study

Ruwei Ou et al. Front Aging Neurosci. .

Abstract

Objective: We investigated the prevalence, evolution, associated factors, and risk factors of apathy in a cohort of patients with early-stage Parkinson's disease (PD), who underwent a 4-years prospective follow-up. Methods: This study included 188 patients with PD (baseline disease duration <3 years) who underwent an annual evaluation using the Lille Apathy Rating Scale (LARS). Based on the cut-off value of -21 observed on the LARS, patients were categorized as PD with and without apathy. The generalized estimating equations (GEE) model was utilized to determine the factors associated with apathy, and the Cox proportional-hazards regression model was used to determine the predictors of apathy. Results: Apathy increased from a baseline rate of 18.6-28.8% after 4 years; notably, this rate was not persistent across patients' visits. The LARS score was independently associated with the male sex (B 8.131, p = 0.009), low Frontal Assessment Battery (FAB) scores (B 0.567, p = 0.011), low attention scores on the Montreal Cognitive Assessment (MOCA) test (B 0.217, p = 0.026), high Hamilton Depression Rating Scale (HDRS) scores (B 1.362, p < 0.001), high Unified Parkinson's Disease Rating Scale (UPDRS) part III scores (B 1.147, p < 0.001), and prolonged follow-up time (B 1.785, p = 0.048). A high HDRS score was the only predictor of apathy in PD [hazard ratio (HR) 1.043, p = 0.026]. Conclusions: The risk of apathy is higher in men with progressive PD accompanied by disease-specific motor and non-motor symptoms. Depression during early-stage PD is a primary risk factor for apathy in PD.

Keywords: Parkinson's disease; apathy; cohort study; depression; executive function.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Frequency of apathy over time in patients with PD. The prevalence of apathy in patients with PD increased with disease duration over time, which increased from 18.6% at baseline to 28.8% after 4 years.
Figure 2
Figure 2
Evolution of apathy in patients with PD over time.
See this image and copyright information in PMC

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