Article Text

Occurrence and risk factors for apathy in Parkinson disease: a 4-year prospective longitudinal study
Free
  1. K F Pedersen1,2,
  2. G Alves1,2,
  3. D Aarsland1,3,4,
  4. J P Larsen1,2,4
  1. 1
    The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway
  2. 2
    Department of Neurology, Stavanger University Hospital, Stavanger, Norway
  3. 3
    Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
  4. 4
    Institute of Clinical Medicine, University of Bergen, Bergen, Norway
  1. Correspondence to Dr K F Pedersen, The Norwegian Centre for Movement Disorders, Stavanger University Hospital, PO Box 8100, N-4068 Stavanger, Norway; kenfrp{at}online.no

Abstract

Background: Apathy is a common but under-recognised behavioural disorder associated with depression and cognitive impairment in patients with Parkinson disease (PD). However, the longitudinal course of apathy in PD has not been studied.

Objective: To examine the occurrence of and risk factors for apathy over time in a representative sample of patients with PD.

Methods: A sample of 139 patients was drawn from a population-based prevalence study of PD in Rogaland County, Western Norway. Apathy was measured with the Neuropsychiatric Inventory, using a composite score ⩾4 to indicate clinically significant apathy. Additional measurements included standardised rating scales for parkinsonism, depression and cognitive impairment. A follow-up evaluation was carried out in 79 patients (78.2% of the survivors) 4 years later.

Results: Of the 79 patients included in this study, 29 patients (36.7%) had never had apathy, 11 (13.9%) had persistent apathy, and a further 39 (49.4%) developed apathy during follow-up. At follow-up, patients with apathy were more frequently depressed and demented than never-apathetic patients. Dementia at baseline and a more rapid decline in speech and axial impairment during follow-up were independent risk factors for incident apathy.

Conclusions: Apathy is a persistent behavioural feature in PD with a high incidence and prevalence over time. Progression of motor signs predominantly mediated by non-dopaminergic systems may be a useful preclinical marker for incident apathy in PD.

View Full Text

Statistics from Altmetric.com

Supplementary materials

Footnotes

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Regional Committee for Medical Research Ethics at the University of Bergen, Norway.

  • Patient consent Obtained.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.