Apathy and cognitive performance in older adults with depression.
OBJECTIVE
Recent studies have linked apathy to frontal lobe dysfunction in persons with dementia, but few studies have explored this relationship in older, depressed persons without dementia. We examined the association between apathy and cognitive function in a group of older persons with major depression using standardized neuropsychological tests. We hypothesized that presence of apathy in depression is associated with poorer frontal executive performance.


METHODS
We analyzed data from 89 older adults with major depression. We defined apathy using four items from the Hamilton Psychiatric Rating Scale for Depression which reflect the clinical state of apathy, including 'diminished work/interest,' 'psychomotor retardation,' 'anergy' and 'lack of insight.'


RESULTS
Apathy most strongly correlated with two verbal executive measures (Stroop C and FAS), a nonverbal executive measure (Wisconsin Card Sorting Test-Other Responses), and a measure of information processing speed (Stroop B). Apathy was not associated with age, sex, education, medical illness burden, Mini-Mental State Examination score and Full Scale IQ score. Stepwise regression analyses of significant cognitive tests showed that apathy alone or apathy plus depression severity, age, or education accounted for a significant amount of the variance.


CONCLUSIONS
The results of this study provide support for an apathy syndrome associated with poorer executive function in older adults with major depression.
Feil
Denise
D
UCLA/VA Greater Los Angeles Health Care System, California 90073, USA. dfeil@mednet.ucla.edu
Razani
Jill
J
Boone
Kyle
K
Lesser
Ira
I
D000342:Affective Symptoms / Q000523:psychology; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D003071:Cognition; D003866:Depressive Disorder / Q000523:psychology*; D004522:Educational Status; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D007360:Intelligence; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D013060:Speech