Lack of Interest Linked With Increased Risk of Dementia

Summary: People who experience severe apathy have a significantly higher risk of developing dementia, a new study reports.

Source: Alzheimer’s Research UK

Research published in the journal Neurology suggests those who lack interest in the world around them are at an increased risk of developing dementia.

The research team looked to see whether developing dementia was linked to apathy. People with apathy often have a lack of interest in the world around them, with signs of apathy including stopping taking part in normal activities, showing little emotion, and a lack of energy. In this study, the team used a questionnaire designed to evaluate apathy in over 2,000 people and to discriminate apathy from depression and anxiety.

They found that severe apathy was linked with an increased risk of dementia compared to low apathy. Image is in the public domain.

They divided the volunteers into groups corresponding to low, moderate, or severe apathy. The team determined whether people developed dementia with an algorithm based on information on dementia medication use, hospital records, or a significant decline in memory and thinking.

The team followed participants over nine years and found 381 volunteers developed likely dementia. They found that severe apathy was linked with an increased risk of dementia compared to low apathy. Apathy was also associated with worse memory and thinking at the beginning of the study, but not rate of change over time.

Dr. Sara Imarisio, Head of Research at Alzheimer’s Research UK, said, “Symptoms of apathy are common in dementia and are not necessarily symptoms of depression. Many people with dementia are mistakenly diagnosed as having depression, particularly in the early stages. Building a better understanding of some of the less well-recognized symptoms of dementia, like apathy, could inform our efforts to develop better treatments for the condition.”

“The scientists in this study used algorithms to identify likely dementia, and a dementia diagnosis wasn’t necessarily confirmed by a doctor. It’s important to understand how health and lifestyle factors can influence dementia risk and it’s still not clear whether apathy contributes to memory problems or vice versa. To continue to unpick this link and make real breakthroughs for people who need them, we need to see sustained investment in dementia research.”

About this Alzheimer’s disease research news

Source: Alzheimer’s Research UK
Contact: Press Office – Alzheimer’s Research UK
Image: The image is in the public domain.

Original Research: Closed access.
Apathy and risk of probable incident dementia among community-dwelling older adults” by Meredith A. Bock, Amber Bahorik, Willa D. Brenowitz, Kristine Yaffe. Neurology


Abstract

Apathy and risk of probable incident dementia among community-dwelling older adults

Objective 
To evaluate the association between baseline apathy and probable incident dementia in a population-based sample of community-dwelling older adults.

Methods 
We studied 2,018 white and black community-dwelling older adults from the Health, Aging, and Body Composition (Health ABC) study. We measured apathy at year 6 (our study baseline) with the modified Apathy Evaluation Scale and divided participants into tertiles based on low, moderate, or severe apathy symptoms. Incident dementia was ascertained over 9 years by dementia medication use, hospital records, or clinically relevant cognitive decline on global cognition. We examined the association between apathy and probable incident dementia using a Cox proportional hazards model adjusting for demographics, cardiovascular risk factors, APOE-4 status, and depressed mood. We also evaluated the association between the apathy group and cognitive change (as measured by the Modified Mini Mental State Examination and Digit Symbol Substitution Test over 5 years) using linear mixed effects models.

Results 
Over 9 years of follow-up, 381 participants developed probable dementia. Severe apathy was associated with an increased risk of dementia compared to low apathy (25% vs 14%) in unadjusted (HR 1.9, 95% CI 1.5–2.5) and adjusted models (HR 1.7, 95% CI 1.3–2.2). Greater apathy was associated with worse cognitive score at baseline, but not rate of change over time.

Conclusion 
In a diverse cohort of community-dwelling adults, apathy was associated with increased risk of developing probable dementia. This study provides novel evidence for apathy as a prodrome of dementia.

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