Syndromic Validity of Apathy in Alzheimer's Disease

OBJECTIVE: The study examined the usefulness and clinical correlates of specific diagnostic criteria for apathy in Alzheimer's disease. Whereas apathy is a frequent behavioral change in patients with Alzheimer's disease, the lack of standardized diagnostic criteria may explain the wide dis...

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Veröffentlicht in:The American journal of psychiatry 2001-06, Vol.158 (6), p.872-877
Hauptverfasser: Starkstein, Sergio E., Petracca, Gustavo, Chemerinski, Erán, Kremer, Janus
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container_end_page 877
container_issue 6
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container_title The American journal of psychiatry
container_volume 158
creator Starkstein, Sergio E.
Petracca, Gustavo
Chemerinski, Erán
Kremer, Janus
description OBJECTIVE: The study examined the usefulness and clinical correlates of specific diagnostic criteria for apathy in Alzheimer's disease. Whereas apathy is a frequent behavioral change in patients with Alzheimer's disease, the lack of standardized diagnostic criteria may explain the wide discrepancies in estimates of the frequency and demographic and clinical correlates of apathy. METHOD: A consecutive series of 319 patients who met the criteria for probable Alzheimer's disease established by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association, 117 patients who met the DSM-IV criteria for depression without dementia, and 36 healthy individuals were assessed with a structured psychiatric interview. On the basis of modified Marin's criteria for apathy, they were classified into groups with or without apathy. RESULTS: Apathy was diagnosed in 37% of the 319 Alzheimer's disease patients, compared to none of the healthy comparison subjects. In 24% of the Alzheimer's disease sample, apathy coexisted with either dysthymic disorder or major depressive disorder, whereas 13% had apathy without depression. Apathy was diagnosed in 32% of the depressed nondemented patients, mostly in those with major depressive disorder. Apathy in Alzheimer's disease was significantly associated with severe impairments in activities of daily living and cognitive functions, older age, and poor awareness of behavioral and cognitive changes. CONCLUSIONS: This study provides partial validation of specific clinical criteria for apathy in Alzheimer's disease.
doi_str_mv 10.1176/appi.ajp.158.6.872
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Whereas apathy is a frequent behavioral change in patients with Alzheimer's disease, the lack of standardized diagnostic criteria may explain the wide discrepancies in estimates of the frequency and demographic and clinical correlates of apathy. METHOD: A consecutive series of 319 patients who met the criteria for probable Alzheimer's disease established by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association, 117 patients who met the DSM-IV criteria for depression without dementia, and 36 healthy individuals were assessed with a structured psychiatric interview. On the basis of modified Marin's criteria for apathy, they were classified into groups with or without apathy. RESULTS: Apathy was diagnosed in 37% of the 319 Alzheimer's disease patients, compared to none of the healthy comparison subjects. In 24% of the Alzheimer's disease sample, apathy coexisted with either dysthymic disorder or major depressive disorder, whereas 13% had apathy without depression. Apathy was diagnosed in 32% of the depressed nondemented patients, mostly in those with major depressive disorder. Apathy in Alzheimer's disease was significantly associated with severe impairments in activities of daily living and cognitive functions, older age, and poor awareness of behavioral and cognitive changes. 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Terminology. Diagnostic criteria ; Prevalence ; Psychiatric Status Rating Scales - statistics &amp; numerical data ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. 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Whereas apathy is a frequent behavioral change in patients with Alzheimer's disease, the lack of standardized diagnostic criteria may explain the wide discrepancies in estimates of the frequency and demographic and clinical correlates of apathy. METHOD: A consecutive series of 319 patients who met the criteria for probable Alzheimer's disease established by the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association, 117 patients who met the DSM-IV criteria for depression without dementia, and 36 healthy individuals were assessed with a structured psychiatric interview. On the basis of modified Marin's criteria for apathy, they were classified into groups with or without apathy. RESULTS: Apathy was diagnosed in 37% of the 319 Alzheimer's disease patients, compared to none of the healthy comparison subjects. In 24% of the Alzheimer's disease sample, apathy coexisted with either dysthymic disorder or major depressive disorder, whereas 13% had apathy without depression. Apathy was diagnosed in 32% of the depressed nondemented patients, mostly in those with major depressive disorder. Apathy in Alzheimer's disease was significantly associated with severe impairments in activities of daily living and cognitive functions, older age, and poor awareness of behavioral and cognitive changes. 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subjects Affective Symptoms - diagnosis
Affective Symptoms - psychology
Aged
Alzheimer Disease - diagnosis
Alzheimer Disease - epidemiology
Alzheimer Disease - psychology
Alzheimer's disease
Apathy
Awareness
Biological and medical sciences
Cognition Disorders - diagnosis
Cognition Disorders - psychology
Comorbidity
Depression - diagnosis
Depression - epidemiology
Depression - psychology
Depressive Disorder - diagnosis
Depressive Disorder - epidemiology
Depressive Disorder - psychology
Dysthymic Disorder - diagnosis
Dysthymic Disorder - psychology
Elderly people
Female
Geriatrics
Health Status
Humans
Male
Medical diagnosis
Medical sciences
Nosology. Terminology. Diagnostic criteria
Prevalence
Psychiatric Status Rating Scales - statistics & numerical data
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Regression Analysis
Reproducibility of Results
Severity of Illness Index
Syndrome
Techniques and methods
title Syndromic Validity of Apathy in Alzheimer's Disease
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