title: Validation of the Lille's Apathy Rating Scale in Very Mild to Moderate Dementia.
abstract: Apathy is one of the most common and disabling syndromes of dementia and presents at all stages of the disease. Comprehensive and structured methods to assess apathy in dementia are still needed. Lille's Apathy Rating Scale (LARS) has shown good psychometric properties for apathy evaluation in Parkinson disease but has not been validated in dementia. The aim of this study was to validate the LARS in a cohort of patients with very mild to moderate dementia.
  
  
  
  101 patients with cognitive impairment (Clinical Dementia Rating ≤ 2) and 50 healthy subjects were recruited. Patient diagnoses included 43 individuals with Alzheimer disease, 41 frontotemporal dementia, and 17 primary progressive aphasia. In addition to LARS, the following assessments were administered: Clinical Dementia Rating, Interview for Deterioration in Daily Living Activities in Dementia, Functional Activities Questionnaire, Frontal Behavioral Inventory, Neuropsychiatric Inventory (NPI), and Hamilton Depression Rating Scale.
  
  
  
  Internal consistency for LARS (Cronbach's alpha) was 0.940. Test-retest intraclass correlation coefficient (ICC) was 0.940 and inter-rater ICC was 0.987. The correlation among LARS and NPI apathy scores (concurrent validity) was 0.834. Receiver operating characteristic analysis estimated an area under the curve of 0.987. The optimal cutoff point was -10. Although total LARS score was influenced by the presence of depression, this disorder was independent with respect to apathy.
  
  
  
  LARS is reliable and valid for detecting and quantifying apathy in patients with dementia, even in very early stages of the disease.
authors.affiliation: Department of Neurology. Hospital Clínico Universitario San Carlos, Universidad Complutense, Madrid, Spain. Electronic address: martafmatarrubia@gmail.com.
authors.forename: Marta
authors.initials: M
authors.lastname: Fernández-Matarrubia
authors.affiliation: Department of Neurology. Hospital Clínico Universitario San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: Jordi A
authors.initials: JA
authors.lastname: Matías-Guiu
authors.affiliation: Department of Neurology. Hospital Clínico Universitario San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Moreno-Ramos
authors.affiliation: Department of Neurology. Hospital Clínico Universitario San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Valles-Salgado
authors.affiliation: Department of Neurology. Hospital Clínico Universitario San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Marcos-Dolado
authors.affiliation: Department of Neurology. Hospital Clínico Universitario San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: García-Ramos
authors.affiliation: Department of Neurology. Hospital Clínico Universitario San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Matías-Guiu
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D057565:Apathy; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000150:complications*; D015331:Cohort Studies; D003863:Depression / Q000523:psychology; D005260:Female; D057180:Frontotemporal Dementia / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics; D012372:ROC Curve; D012044:Regression Analysis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013030:Spain
keywords: Apathy; dementia; psychometrics; rating scale; validation study