title: Apathy is more severe in vascular than amnestic mild cognitive impairment in a community: the Kurihara Project.
abstract: OBJECTIVE
  The aim of this study was to estimate the prevalence of apathy, and to compare vascular mild cognitive impairment (vMCI), amnestic MCI (amMCI), and other type using Clinical Assessment for Spontaneity (CAS).
  
  
  METHODS
  Agreement to take part in the study was obtained from 590 community dwellers, aged ≥75 years living in Kurihara, Japan. Of the 590 subjects, 221 had a clinical dementia rating (CDR) of 0 (normal); 295 had CDR 0.5 (mild cognitive impairment; MCI); and 74 had CDR 1+ (dementia). The CDR 0.5 subjects were divided into three groups: 55 with vMCI (Erkinjuntti et al. criteria), 91 with amMCI and 149 with other type. To evaluate the various aspects of apathy, we used the three CAS subscales: clinical interview (CAS1), self-evaluation (CAS2), and caregiver assessment (CAS3). Three analyses were then performed to determine: (i) the validity of CAS; (ii) the prevalence rate of apathy in CDR 0 versus CDR 0.5 versus CDR 1+; and (iii) the prevalence rate of apathy in normal versus vMCI versus amMCI versus other type.
  
  
  RESULTS
  CAS was validated with the Apathy Evaluation Scale. There were significant differences among the three CDR groups in CAS1, CAS2 and CAS3 (P < 0.001). The prevalence rate of apathy in each CAS in the CDR 1+ group was higher than the CDR 0.5 group, which was higher than the CDR 0 group. There was a significant difference in CAS3 score between the four groups (the normal and the three subgroups; P < 0.001). Apathy in vMCI was more severe than in the other three groups (P < 0.05) on CAS3 score.
  
  
  CONCLUSIONS
  vMCI subjects have more severe apathy compared with amMCI subjects on caregiver assessment.
authors.affiliation: Department of Geriatric Behavioral Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Nakamura
authors.forename: Mari
authors.initials: M
authors.lastname: Kasai
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Ouchi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakatsuka
authors.forename: Naofumi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Kato
authors.forename: Megumi
authors.initials: M
authors.lastname: Nakai
authors.forename: Kenichi
authors.initials: K
authors.lastname: Meguro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000647:Amnesia / Q000523:psychology*; D057565:Apathy; D017028:Caregivers; D060825:Cognitive Dysfunction / Q000523:psychology*; D015140:Dementia, Vascular / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index
keywords: apathy; clinical dementia rating; dementia; mild cognitive impairment; subcortical vascular dementia