Abstract Details

Title Apathy is Associated with Risk of Incident Dementia Among Community-Dwelling Older Adults

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM)

Poster/Presentation
Number 10-004

Objective To prospectively evaluate the association between symptoms of apathy and incident dementia in a diverse cohort of community-dwelling adults

Background Apathy is prevalent in all dementia subtypes and may be an important prodromal sign associated with progression to dementia, yet this has not been rigorously investigated in a population-based sample.

Design/Methods We studied 2,023 participants from the Health, Aging, and Body Composition (Health ABC) study, a prospective cohort of community-dwelling white and black older adults. The modified Apathy Evaluation Scale was administered at year 6, our study baseline. Prevalent dementia was excluded and incident dementia was measured through Year 15, determined by dementia medication use, hospital records, or significant decline in global cognition (≥ 1.5 SD race-specific decline on the Modified Mini-Mental State Examination (3MS)). We examined the association between baseline apathy tertile and incident dementia using a logistic regression model. We adjusted the model for age, gender, race, education level, and comorbid depression (measured by the Center for Epidemiologic Studies Depression Scale). We used a linear mixed effects model to evaluate the association between baseline apathy tertile and cognitive decline, as measured by the 3MS and Digit Symbol Substitution Test through year 10.

Results There were 381 (18%) cases of incident dementia over 9 years of follow-up. Severe apathy was associated with risk of incident dementia in unadjusted (OR 1.9, 95% CI 1.5-2.6) and adjusted models (25% vs. 14%, OR 1.5, 95% CI 1.1-2.1). Severity of apathy predicted cognitive scores at the study baseline but not change in cognition over time.

Conclusions In a diverse cohort of community-dwelling adults, apathy was associated with increased risk of developing dementia. A brief assessment of apathy may have clinical utility in risk stratifying the elderly for progression to dementia.

Authors/Disclosures
Meredith Bock, MD (UCSF Center for Surgical Movement Disorders) PRESENTER	The institution of Dr. Bock has received research support from American Academy of Neurology. The institution of Dr. Bock has received research support from Michael J Fox Foundation.
	No disclosure on file
	No disclosure on file
Kristine Yaffe, MD	Dr. Yaffe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Yaffe has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Quintiles. Dr. Yaffe has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Alector. The institution of Dr. Yaffe has received research support from NIH. The institution of Dr. Yaffe has received research support from DOD. The institution of Dr. Yaffe has received research support from Veterans Affairs.