Apathy, but not depression, predicts all-cause dementia in cerebral small vessel disease. Issue 9 (10th July 2020)

• Record Type: Journal Article
• Authors: Tay, Jonathan; Morris, Robin G; Tuladhar, Anil M; Husain, Masud; de Leeuw, Frank-Erik; Markus, Hugh S
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 91:Issue 9(2020)
• Page Start: 953
• Page End: 959
• Publication Date: 2020-07-10
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2020-323092
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objective: To determine whether apathy or depression predicts all-cause dementia in small vessel disease (SVD) patients. Methods: Analyses used two prospective cohort studies of SVD: St. George's Cognition and Neuroimaging in Stroke (SCANS; n=121) and Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC; n=352). Multivariate Cox regressions were used to predict dementia using baseline apathy and depression scores in both datasets. Change in apathy and depression was used to predict dementia in a subset of 104 participants with longitudinal data from SCANS. All models were controlled for age, education and cognitive function. Results: Baseline apathy scores predicted dementia in SCANS (HR 1.49, 95% CI 1.05 to 2.11, p=0.024) and RUN DMC (HR 1.05, 95% CI 1.01 to 1.09, p=0.007). Increasing apathy was associated with dementia in SCANS (HR 1.53, 95% CI 1.08 to 2.17, p=0.017). In contrast, baseline depression and change in depression did not predict dementia in either dataset. Including apathy in predictive models of dementia improved model fit. Conclusions: Apathy, but not depression, may be a prodromal symptom of dementia in SVD, and may be useful in identifying at-risk individuals.