title: Apathy in untreated, de novo patients with Parkinson's disease: validation study of Apathy Evaluation Scale.
abstract: Apathy is a behavioural disturbance occurring alone or in concomitance with depression in Parkinson's disease (PD). Here we present a validation study for the self-report version of the Apathy Evaluation Scale (AES-S), carried out in a sample of 60 non-demented, non-depressed untreated, drug-naïve, de novo PD patients; 20 patients of the sample (33.3%) were classified as apathetic according to current clinical criteria. All enrolled patients completed the AES-S and a neurological and cognitive assessment. Mean AES-S score was 34.43. AES-S did not show floor or ceiling effect. Cronbach's alpha was 0.872. Principal component analysis revealed three factors: the first (34.4% of the variance) represented constitutive aspects of the construct of apathy; the second (8.5% of the variance) represented a social dimension; the third factor (7.9% of the variance) represented a dimension related to insight. With respect to clinical criteria for apathy considered as the gold standard, receiver operating characteristics curve analysis showed that a cut-off of 36/37 has the maximum discrimination power. High sensitivity and negative predictive values were obtained with cut-off scores of 33/34 or lower; high specificity and positive predictive values were obtained with cut-off scores of 38/39 or higher. AES-S score correlated with scores on frontal tasks, but not on Beck Depression Inventory, Unified Parkinson's Disease Rating Scale, Hoehn and Yahr scale. The AES-S is a reliable and valid questionnaire for detecting apathy in PD. For screening purposes a 33/34 cut-off score is indicated, but a 38/39 cut-off score is necessary when a high specificity is desired.
authors.affiliation: Department of Psychology, Second University of Naples, Caserta, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Santangelo
authors.forename: Paolo
authors.initials: P
authors.lastname: Barone
authors.forename: Sofia
authors.initials: S
authors.lastname: Cuoco
authors.forename: Simona
authors.initials: S
authors.lastname: Raimo
authors.forename: Domenica
authors.initials: D
authors.lastname: Pezzella
authors.forename: Marina
authors.initials: M
authors.lastname: Picillo
authors.forename: Roberto
authors.initials: R
authors.lastname: Erro
authors.forename: Marcello
authors.initials: M
authors.lastname: Moccia
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Pellecchia
authors.forename: Marianna
authors.initials: M
authors.lastname: Amboni
authors.forename: Franco
authors.initials: F
authors.lastname: Santangelo
authors.forename: Santangelo
authors.initials: S
authors.lastname: Franco
authors.forename: Dario
authors.initials: D
authors.lastname: Grossi
authors.forename: Luigi
authors.initials: L
authors.lastname: Trojano
authors.forename: Carmine
authors.initials: C
authors.lastname: Vitale
mesh_terms: D000368:Aged; D057565:Apathy; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology* / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000592:standards* / Q000706:statistics & numerical data; D011594:Psychometrics / Q000379:methods*; D057566:Self Report; D012680:Sensitivity and Specificity