Tags

Type your tag names separated by a space and hit enter

Neuropsychiatric predictors of progression from amnestic-mild cognitive impairment to Alzheimer's disease: the role of depression and apathy.
J Alzheimers Dis. 2010; 20(1):175-83.JA

Abstract

The aim of the study is to evaluate whether depression or apathy in patients with amnestic-mild cognitive impairment (MCI) increases the risk of progressing to Alzheimer's disease (AD). We investigated 131 consecutive memory-clinic outpatients with newly-diagnosed amnestic-MCI (mean age 70.8, SD=6.5). Psychiatric disorders were diagnosed at baseline according to the criteria for depression and apathy in AD. Neuropsychiatric symptoms were assessed with the Neuropsychiatric Inventory (NPI). Follow-up examinations were conducted after six months and annually for four years. Neurologists diagnosed AD at follow-up using NINCDS-ADRDA criteria. Cox proportional hazard models with 95% confidence intervals were used to test the hypothesis that apathy or depression increases the risk of developing AD. At baseline, 36.6% amnestic-MCI patients had a diagnosis of depression and 10.7% had apathy. Patients with both amnestic-MCI and an apathy diagnosis had an almost sevenfold risk of AD progression compared to amnestic-MCI patients without apathy (HR=6.9; 2.3-20.6), after adjustment for age, gender, education, baseline global cognitive and functional status, and depression. Furthermore, the risk of developing AD increased 30% per point on the NPI apathy item (HR=1.3; 1.1-1.4). There was no increased risk of developing AD in amnestic-MCI patients with either a diagnosis or symptoms of depression. In conclusion, apathy, but not depression, predicts which patients with amnestic-MCI will progress to AD. Thus, apathy has an important impact on amnestic-MCI and should be considered a mixed cognitive/psychiatric disturbance related to ongoing AD neurodegeneration.

Authors+Show Affiliations

Fondazione Santa Lucia, Instituto di Ricovero e Cura a Carettere Scientifico, Rome, Italy. k.palmer@hsantalucia.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20164594

Citation

Palmer, Katie, et al. "Neuropsychiatric Predictors of Progression From Amnestic-mild Cognitive Impairment to Alzheimer's Disease: the Role of Depression and Apathy." Journal of Alzheimer's Disease : JAD, vol. 20, no. 1, 2010, pp. 175-83.
Palmer K, Di Iulio F, Varsi AE, et al. Neuropsychiatric predictors of progression from amnestic-mild cognitive impairment to Alzheimer's disease: the role of depression and apathy. J Alzheimers Dis. 2010;20(1):175-83.
Palmer, K., Di Iulio, F., Varsi, A. E., Gianni, W., Sancesario, G., Caltagirone, C., & Spalletta, G. (2010). Neuropsychiatric predictors of progression from amnestic-mild cognitive impairment to Alzheimer's disease: the role of depression and apathy. Journal of Alzheimer's Disease : JAD, 20(1), 175-83. https://doi.org/10.3233/JAD-2010-1352
Palmer K, et al. Neuropsychiatric Predictors of Progression From Amnestic-mild Cognitive Impairment to Alzheimer's Disease: the Role of Depression and Apathy. J Alzheimers Dis. 2010;20(1):175-83. PubMed PMID: 20164594.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neuropsychiatric predictors of progression from amnestic-mild cognitive impairment to Alzheimer's disease: the role of depression and apathy. AU - Palmer,Katie, AU - Di Iulio,Fulvia, AU - Varsi,Ambra Erika, AU - Gianni,Walter, AU - Sancesario,Giuseppe, AU - Caltagirone,Carlo, AU - Spalletta,Gianfranco, PY - 2010/2/19/entrez PY - 2010/2/19/pubmed PY - 2010/7/9/medline SP - 175 EP - 83 JF - Journal of Alzheimer's disease : JAD JO - J. Alzheimers Dis. VL - 20 IS - 1 N2 - The aim of the study is to evaluate whether depression or apathy in patients with amnestic-mild cognitive impairment (MCI) increases the risk of progressing to Alzheimer's disease (AD). We investigated 131 consecutive memory-clinic outpatients with newly-diagnosed amnestic-MCI (mean age 70.8, SD=6.5). Psychiatric disorders were diagnosed at baseline according to the criteria for depression and apathy in AD. Neuropsychiatric symptoms were assessed with the Neuropsychiatric Inventory (NPI). Follow-up examinations were conducted after six months and annually for four years. Neurologists diagnosed AD at follow-up using NINCDS-ADRDA criteria. Cox proportional hazard models with 95% confidence intervals were used to test the hypothesis that apathy or depression increases the risk of developing AD. At baseline, 36.6% amnestic-MCI patients had a diagnosis of depression and 10.7% had apathy. Patients with both amnestic-MCI and an apathy diagnosis had an almost sevenfold risk of AD progression compared to amnestic-MCI patients without apathy (HR=6.9; 2.3-20.6), after adjustment for age, gender, education, baseline global cognitive and functional status, and depression. Furthermore, the risk of developing AD increased 30% per point on the NPI apathy item (HR=1.3; 1.1-1.4). There was no increased risk of developing AD in amnestic-MCI patients with either a diagnosis or symptoms of depression. In conclusion, apathy, but not depression, predicts which patients with amnestic-MCI will progress to AD. Thus, apathy has an important impact on amnestic-MCI and should be considered a mixed cognitive/psychiatric disturbance related to ongoing AD neurodegeneration. SN - 1875-8908 UR - https://www.unboundmedicine.com/medline/citation/20164594/Neuropsychiatric_predictors_of_progression_from_amnestic_mild_cognitive_impairment_to_Alzheimer's_disease:_the_role_of_depression_and_apathy_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JAD-2010-1352 DB - PRIME DP - Unbound Medicine ER -