Hostname: page-component-8448b6f56d-jr42d Total loading time: 0 Render date: 2024-04-16T05:40:42.544Z Has data issue: false hasContentIssue false
  • English
  • Français

Do people become more apathetic as they grow older? A longitudinal study in healthy individuals

Published online by Cambridge University Press:  15 December 2009

Henry Brodaty ,
Annette Altendorf ,
Adrienne Withall  and
Perminder Sachdev
Henry Brodaty*
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Primary Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia
Annette Altendorf
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia
Adrienne Withall
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Primary Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia
Perminder Sachdev
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia Primary Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
*
Correspondence should be addressed to: Professor Henry Brodaty, Academic Department for Old Age Psychiatry, The Euroa Centre, Prince of Wales Hospital, Avoca St, Randwick, Sydney, NSW 2031, Australia. Phone: +61 2 9382 3759; Fax: +61 2 9382 3762. Email: h.brodaty@unsw.edu.au.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The aim of this study was to determine levels, rates and progression of apathy in healthy older persons and to investigate factors associated with its progression.

Methods: Seventy-six healthy elderly subjects, aged 58–85 years (mean 69.9), who were recruited by general advertisement and through local community groups, participated as a control group for a longitudinal study of stroke patients. Data were collected on demographic, psychological, neuropsychological and neuroimaging (MRI) variables and apathy was rated by informants on the Apathy Evaluation Scale (AES).

Results: Apathy scores and rates increased over 5 years, especially in men. Change of apathy was associated with informant ratings of cognitive decline in the years prior to baseline assessment but not to subsequent neuropsychological, neuroimaging or functional changes.

Conclusions: Apathy increases with age in otherwise healthy community-dwelling individuals, particularly in men.

Keywords

apathymotivationhealthy elderlyaginglongitudinal study
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 3 , May 2010 , pp. 426 - 436
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, K. B. (2001). Depressive symptoms, depletion, or developmental change? Withdrawal, apathy, and lack of vigor in the Geriatric Depression Scale. The Gerontologist, 41, 768–777.CrossRefGoogle ScholarPubMed
Agostini, J. V., Han, L. and Tinetti, M. E. (2004). The relationship between number of medications and weight loss or impaired balance in older adults. Journal of the American Geriatrics Society, 52, 1719–1723.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn.Washington, DC: American Psychiatric Association.Google Scholar
Andersson, S., Krogstad, J. M. and Finset, A. (1999). Apathy and depressed mood in acquired brain damage: relationship to lesion localization and psychophysiological reactivity. Psychological Medicine, 29, 447–456.CrossRefGoogle ScholarPubMed
Archer, N. et al. (2007). Premorbid personality and behavioral and psychological symptoms in probable Alzheimer disease. American Journal of Geriatric Psychiatry, 15, 202–213.CrossRefGoogle ScholarPubMed
Benoit, M., Koulibaly, P., Migneco, O., Darcourt, J., Pringuey, D. and Robert, P. (2002). Brain perfusion in Alzheimer's disease with and without apathy: a SPECT study with statistical parametric mapping analysis. Psychiatry Research: Neuroimaging, 114, 103–111.CrossRefGoogle Scholar
Benoit, M. et al. (2008). Apathy and depression in Alzheimer's disease are associated with functional deficit and psychotropic prescription. International Journal of Geriatric Psychiatry, 23, 409–414.CrossRefGoogle ScholarPubMed
Bogousslavsky, J., Regli, F., Delaloye, B., Delaloye-Bischof, A., Assal, G. and Uske, A. (1991). Loss of psychic self-activation with bithalamic infarction: neurobehavioural, CT, MRI and SPECT correlates. Acta Neurologica Scandinavica, 83, 309–316.CrossRefGoogle ScholarPubMed
Borek, L. L., Chou, K. L. and Friedman, J. H. (2007). Management of the behavioral aspects of Parkinson's disease. Expert Review of Neurotherapeutics, 7, 711–725.CrossRefGoogle ScholarPubMed
Bourre, J. M. (2006). Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. Journal of Nutrition, Health and Aging, 10, 377–385.Google ScholarPubMed
Brodaty, H., Sachdev, P. S., Withall, A., Altendorf, A., Valenzuela, M. J. and Lorentz, L. (2005). Frequency and clinical, neuropsychological and neuroimaging correlates of apathy following stroke – the Sydney Stroke Study. Psychological Medicine, 35, 1707–1716.CrossRefGoogle ScholarPubMed
Clarke, D. E. et al. (2008). Apathy in dementia: clinical and sociodemographic correlates. Journal of Neuropsychiatry and Clinical Neurosciences, 20, 337–347.CrossRefGoogle ScholarPubMed
Cumming, E. and Henry, W. (1961). Growing Old: The Process of Disengagement. New York: Basic Books.Google Scholar
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Drentea, P. (2002). Retirement and mental health. Journal of Aging and Health, 2, 167–194.CrossRefGoogle Scholar
Fazekas, F., Chawluk, J., Alavi, A., Hurtig, H. I. and Zimmerman, R. A. (1987). MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. American Journal of Roentgenology, 149, 351–356.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Galynker, I., Prikhojan, A., Phillips, E., Focseneanu, M., Ieronimo, C. and Rosenthal, R. (1997). Negative symptoms in stroke patients and length of hospital stay. Journal of Nervous and Mental Disease, 185, 616–621.CrossRefGoogle ScholarPubMed
Ghika-Schmid, F. and Bogousslavsky, J. (2000). The acute behavioral syndrome of anterior thalamic infarction: a prospective study of 12 cases. Annals of Neurology, 48, 220–227.3.0.CO;2-M>CrossRefGoogle ScholarPubMed
Goodglass, H. and Kaplan, E. (1983). The Assessment of Aphasia and Related Disorders. Philadelphia: Lea & Febiger.Google Scholar
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56–62.CrossRefGoogle ScholarPubMed
Helgason, C., Wilbur, A., Weiss, A., Redmond, K. J. and Kingsbury, N. A. (1988). Acute pseudobulbar mutism due to discrete bilateral capsular infarction in the territory of the anterior choroidal artery. Brain, 111, 507–524.CrossRefGoogle ScholarPubMed
Jorm, A. F. (1994). A short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): development and cross-validation. Psychological Medicine, 24, 145–153.CrossRefGoogle Scholar
Kant, R., Duffy, J. D. and Pivovarnik, A. (1998). Prevalence of apathy following head injury. Brain Injury, 12, 87–92.CrossRefGoogle ScholarPubMed
Katz, S. and Akpom, C. A. (1976). A measure of primary sociobiological functions. International Journal of Health Services: Planning, Administration, Evaluation, 6, 493–508CrossRefGoogle ScholarPubMed
Kincaid, C. (2005). Guidelines for Selecting the Covariance Structure in Mixed Model Analysis. Available at: www2.sas.com/proceedings/sugi30/198-30.pdf.Google Scholar
Lampe, I. K. and Heeren, T. (2004). Is apathy in late-life depressive illness related to age-at-onset, cognitive function or vascular risk? International Psychogeriatrics, 16, 481–486.CrossRefGoogle ScholarPubMed
Landes, A. M., Sperry, S. D., Strauss, M. E. and Geldmacher, D. S. (2001). Apathy in Alzheimer's disease. Journal of the American Geriatrics Society, 49, 1700–1707.CrossRefGoogle ScholarPubMed
Landes, A., Sperry, S. and Strauss, M. (2005). Prevalence of apathy, dysphoria, and depression in relation to dementia severity in Alzheimer's disease Journal of Neuropsychiatry and Clinical Neurosciences, 17, 342–349.CrossRefGoogle ScholarPubMed
Lavretsky, H., Ballmaier, M., Pham, D., Toga, A. and Kumar, A. (2007). Neuroanatomical characteristics of geriatric apathy and depression: a magnetic resonance imaging study. American Journal of Geriatric Psychiatry, 15, 386–394.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Lenze, E. et al. (2007). Onset of depression in elderly persons after hip fracture: implications for prevention and early intervention of late-life depression. Journal of the American Geriatrics Society, 55, 81–86.CrossRefGoogle ScholarPubMed
Levy, M. L. et al. (1998). Apathy is not depression. Journal of Neuropsychiatry, 10, 314–319.CrossRefGoogle Scholar
Lyketsos, C., Lopez, O., Jones, B., Fitzpatrick, A. L., Breitner, J. and DeKosky, S. (2002). Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment: results from the Cardiovascular Health Study. JAMA, 288, 1475–1483.CrossRefGoogle ScholarPubMed
Marin, R. S. (1990). Differential diagnosis and classification of apathy. American Journal of Psychiatry, 147, 22–30.Google ScholarPubMed
Marin, R. (1991). Apathy: a neuropsychiatric syndrome. Journal of Neuropsychiatry, 3, 243–254.Google Scholar
Marin, R. S., Biedrzycki, R. C. and Firinciogullari, S. (1991). Reliability and validity of the Apathy Evaluation Scale. Psychiatry Research, 38, 143–162.CrossRefGoogle ScholarPubMed
Marin, R. S., Firinciogullari, S. and Biedrzycki, R. C. (1993). The sources of convergence between measures of apathy and depression. Journal of Affective Disorders, 28, 117–124.CrossRefGoogle ScholarPubMed
McCallister, T. W. (2000). Apathy. Seminars in Clinical Neurology, 5, 275–282.Google Scholar
Nelson, H. (1983). National Adult Reading Test (NART): Test Manual. 2nd edn.Windsor: NFER-Nelson.Google Scholar
Okada, K., Kobayashi, S., Yamagata, S., Takahashi, K. and Yamaguchi, S. (1997). Poststroke apathy and regional cerebral blood flow. Stroke, 28, 2437–2441.CrossRefGoogle ScholarPubMed
Onyike, C. U. et al. (2007). Epidemiology of apathy in older adults: the Cache County Study. American Journal of Geriatric Psychiatry, 15, 365–375.CrossRefGoogle ScholarPubMed
Palmore, E. B., Fillenbaum, G. G. and George, L. K. (1984). Consequences of retirement. Journal of Gerontology, 39, 109–116.CrossRefGoogle ScholarPubMed
Parmalee, P., Lawton, M. P. and Katz, I. R. (1989). Psychometric properties of the Geriatric Depression Scale among the institutionalized aged. Psychological Assessment, 1, 331–338.CrossRefGoogle Scholar
Rasmussen, H. H., Mortensen, P. B. and Jensen, I. W. (1989). Depression and magnesium deficiency. International Journal of Psychiatry in Medicine, 19, 57–63.CrossRefGoogle ScholarPubMed
Resnick, B., Zimmerman, S. I., Magaziner, J. and Adelman, A. (1998). Use of the Apathy Evaluation scale as a measure of motivation in elderly people. Rehabilitation Nursing, 23, 141–147.CrossRefGoogle ScholarPubMed
Robinson, R. G., Kubos, K. L., Starr, L. B., Rao, K. and Price, T. R. (1984). Mood disorders in stroke patients: importance of location of lesion. Brain, 107, 81–93.CrossRefGoogle ScholarPubMed
Robinson, R. G. and Starkstein, S. E. (1990). Current research in affective disorders following stroke. Journal of Neuropsychiatry and Clinical Neurosciences, 2, 1–14.Google ScholarPubMed
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. In Brink, T. L. (ed.), Clinical Gerontology: A Guide to Assessment and Intervention (pp. 165–173). New York: The Haworth Press, Inc.Google Scholar
Starkstein, S. E., Federoff, J. P., Price, T. R., Leiguarda, R. and Robinson, R. G. (1993). Apathy following cerebrovascular lesions. Stroke, 24, 1625–1630.CrossRefGoogle ScholarPubMed
Tenover, J. S. (1992). Effects of testosterone supplementation in the aging male. Journal of Clinical Endocrinology and Metabolism, 75, 1092–1098.Google ScholarPubMed
van Solinge, H. (2007). Health change in retirement: a longitudinal study among older workers in the Netherlands. Research on Aging, 3 225–256.CrossRefGoogle Scholar
Verkaik, R., van Weert, J. C. M. and Francke, A. L. (2005). The effects of psychosocial methods on depressed, aggressive and apathetic behaviors of people with dementia: a systematic review. International Journal of Geriatric Psychiatry, 20, 301–314.CrossRefGoogle ScholarPubMed
Yamagata, S., Yamaguchi, S. and Kobayashi, S. (2004). Impaired novelty processing in apathy after subcortical stroke. Stroke, 35, 1935–1940.CrossRefGoogle ScholarPubMed
Zawacki, T. M. et al. (2002). Behavioural problems as predictors of functional abilities of vascular dementia patients. Journal of Neuropsychiatry and Clinical Neurosciences, 14, 296–302.CrossRefGoogle Scholar