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Apathy, but not depression, predicts all-cause dementia in cerebral small vessel disease

Research output: Contribution to journalArticle

Jonathan Tay, Robin G. Morris, Anil M. Tuladhar, Masud Husain, Frank Erik De Leeuw, Hugh S. Markus

Original languageEnglish
Article numberjnnp-2020-323092
Pages (from-to)953-959
Number of pages7
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume91
Issue number9
DOIs
Publication statusPublished - 1 Sep 2020

King's Authors

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.

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