title: Closing-in is related to apathy in Alzheimer's disease patients.
abstract: BACKGROUND
  Apathy and depression are behavioral manifestations that may occur often in Alzheimer's disease (AD) patients. AD patients may also show Closing-in (CI) phenomenon, in graphic copying tasks. Recent evidence would suggest that apathetic symptoms are related to frontal dysfunctions in AD patients, whereas the cognitive bases of depressive symptoms in AD are still unclear. Recent studies demonstrated that frontal dysfunctions are also involved in the genesis of CI in AD patients.
  
  
  OBJECTIVE
  Since frontal dysfunctions are thought to be more strongly related to apathetic than depressive symptoms, here we tested the hypothesis that CI is significantly associated with apathy in AD patients.
  
  
  METHODS
  Forty-four AD patients were enrolled for this study. All patients completed a neuropsychological evaluation of visuo-spatial, frontal/executive, visuo-constructional, and memory skills. Moreover, graphic copying tasks were employed to detect CI, and behavioral scales to assess apathetic and depressive symptoms.
  
  
  RESULTS
  CI and apathetic and depressed symptoms occurred in more than half of the present AD sample, but regression models revealed that the number of CI was significantly related to apathy only. The number of CI was also significantly correlated with severity of apathetic but not of depressive symptoms.
  
  
  CONCLUSIONS
  The present study demonstrated that CI and apathy are correlated with each other in mild to moderate AD, likely because they share common pathogenic mechanisms related to frontal/executive dysfunctions.
authors.affiliation: Neuropsychology Laboratory, Department of Psychology, Second University of Naples, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Grossi
authors.affiliation: Neuropsychology Laboratory, Department of Psychology, Second University of Naples, Italy.
authors.forename: Natascia
authors.initials: N
authors.lastname: de Lucia
authors.affiliation: Neuropsychology Laboratory, Department of Psychology, Second University of Naples, Italy Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Trojano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology / Q000523:psychology*; D057565:Apathy / Q000502:physiology*; D001288:Attention / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D009483:Neuropsychological Tests
keywords: Alzheimer's disease; apathy; closing-in; depression; frontal defect