title: The Apathy Evaluation Scale: A Comparison of Subject, Informant, and Clinician Report in Cognitively Normal Elderly and Mild Cognitive Impairment.
abstract: BACKGROUND
  Apathy is a common neuropsychiatric symptom in Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI). Detecting apathy accurately may facilitate earlier diagnosis of AD. The Apathy Evaluation Scale (AES) is a promising tool for measurement of apathy in prodromal and possibly preclinical AD.
  
  
  OBJECTIVE
  To compare the three AES sub-scales - subject-reported (AES-S), informant-reported (AES-I), and clinician-reported (AES-C) - over time in individuals at risk for AD due to MCI and advanced age (cognitively normal [CN] elderly).
  
  
  METHODS
  Mixed effects longitudinal models were used to assess predictors of score for each AES sub-scale. Cox proportional hazards models were used to assess which AES sub-scales predict progression from MCI to AD dementia.
  
  
  RESULTS
  Fifty-seven MCI and 18 CN subjects (ages 53-86) were followed for 1.4 ± 1.2 years and 0.7 ± 0.7 years, respectively. Across the three mixed effects longitudinal models, the common findings were associations between greater apathy and greater years in study, a baseline diagnosis of MCI (compared to CN), and male gender. CN elderly self-reported greater apathy compared to that reported by informants and clinicians, while individuals with MCI under-reported their apathy compared to informants and clinicians. Of the three sub-scales, the AES-C best predicted transition from MCI to AD dementia.
  
  
  CONCLUSIONS
  In a sample of CN elderly and elderly with MCI, apathy increased over time, particularly in men and those with MCI. AES-S scores may be more sensitive than AES-I and AES-C scores in CN elderly, but less reliable if subjects have MCI. Moreover, the AES-C sub-scale predicted progression from MCI to AD dementia.
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Brendan J
authors.initials: BJ
authors.lastname: Guercio
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.|Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Donovan
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Munro
authors.affiliation: Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Aghjayan
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Wigman
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Locascio
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.|Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Amariglio
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.|Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Dorene M
authors.initials: DM
authors.lastname: Rentz
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.|Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Johnson
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Reisa A
authors.initials: RA
authors.lastname: Sperling
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Center for Alzheimer Research and Treatment, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA.|Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Gad A
authors.initials: GA
authors.lastname: Marshall
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D000544:Alzheimer Disease / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D057565:Apathy; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010465:Perception; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors
keywords: Aged; Alzheimer’s disease; apathy; mild cognitive impairment; symptom assessment