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Low-grade inflammation differentiates between symptoms of apathy and depression in community-dwelling older individuals

  • Lisa S. M. Eurelings (a1), Edo Richard (a2), Piet Eikelenboom (a1) (a3) (a4), Willem A. van Gool (a1) and Eric P. Moll van Charante (a5)...



Systemic low-grade inflammation has repeatedly been associated with depression in old age, but the relationship with apathy is less clear. The present study assessed whether C-reactive protein (CRP) is differentially associated with symptoms of apathy and depression.


A population-based cohort study was carried-out. At baseline and after two and four years of follow-up, CRP levels were assessed and symptoms of apathy and depression were measured using the 15-item Geriatric Depression Scale. Logistic regression analysis was used to investigate the cross-sectional and longitudinal associations of CRP with symptoms of apathy and depression.


Two thousand forty-seven community-dwelling participants (70–78 years) without a history of cardiovascular disease or stroke were studied. A cross-sectional association was found between CRP and apathy symptoms at three time points (odds ratio (OR) per natural log unit increase in CRP: baseline visit = 1.40, 95% CI = 1.12–1.75; two-year follow-up visit = 1.62, 95% CI = 1.17–2.25; four-year follow-up visit = 1.51, 95% CI = 1.03–2.21). This did not change after adjustment for demographics and depressive symptoms, and was slightly attenuated after adjustment for cardiovascular risk factors. No cross-sectional association was found with depressive symptoms. Baseline CRP did not predict incident apathy or depressive symptoms during four years of follow-up.


Increased CRP levels are associated with apathy symptoms but not with depressive symptoms. This suggests a differential effect of inflammation on apathy and depression. In older persons, symptoms of apathy may be a behavioral manifestation of concurrent low-grade inflammation.


Corresponding author

Correspondence should be addressed to: Lisa S. M. Eurelings, Academic Medical Center, department of Neurology, room H2-235, PO Box 22660, 1100 DD Amsterdam, the Netherlands. Phone: +31 20 5663446; Fax: +31 20 5669290. Email:


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Low-grade inflammation differentiates between symptoms of apathy and depression in community-dwelling older individuals

  • Lisa S. M. Eurelings (a1), Edo Richard (a2), Piet Eikelenboom (a1) (a3) (a4), Willem A. van Gool (a1) and Eric P. Moll van Charante (a5)...


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