title: Symptoms of Apathy Independently Predict Incident Frailty and Disability in Community-Dwelling Older Adults.
abstract: OBJECTIVE
  Although depressive symptoms are widely recognized as a predictor of functional decline among older adults, little is known about the predictive utility of apathy in this population. We prospectively examined apathy symptoms as predictors of incident slow gait, frailty, and disability among non-demented, community-dwelling older adults.
  
  
  METHODS
  We examined 2 independent prospective cohort studies-the LonGenity study (N = 625, 53% women, mean age = 75.2 years) and the Central Control of Mobility in Aging (CCMA) study (N = 312, 57% women, mean age = 76.4 years). Individuals were recruited from 2008 to 2014. Apathy was assessed using 3 items from the Geriatric Depression Scale. Slow gait was defined as 1 standard deviation or more below age- and sex-adjusted mean values, frailty was defined using the Cardiovascular Health Study criteria, and disability was assessed with a well-validated disability scale.
  
  
  RESULTS
  The prevalence of apathy was 20% in the LonGenity cohort and 26% in the CCMA cohort. The presence of apathy at baseline, independent of depressive symptoms (besides apathy), increased the risk of developing incident slow gait (hazard ratio [HR] = 2.10; 95% CI, 1.36-3.24; P = .001), frailty (HR = 2.86; 95% CI, 1.96-4.16; P < .001), and disability (HR = 3.43; 95% CI, 1.73-6.79; P < .001) in the pooled sample. These associations remained significant when accounting for demographics, medical illnesses, and cognitive function.
  
  
  CONCLUSIONS
  Apathy is associated with increased risk of developing slow gait, frailty, and disability, independent of other established risk factors, in non-demented older adults. Apathy should be screened for as a potentially preventable cause of functional decline in clinical psychiatric settings.
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Emmeline
authors.initials: E
authors.lastname: Ayers
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Miriam
authors.initials: M
authors.lastname: Shapiro
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.|Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA.
authors.forename: Roee
authors.initials: R
authors.lastname: Holtzer
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.|Department of Genetics, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Nir
authors.initials: N
authors.lastname: Barzilai
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Sofiya
authors.initials: S
authors.lastname: Milman
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine, 1225 Morris Park Ave, Van Etten 308, Bronx, NY 10461. joe.verghese@einstein.yu.edu.|Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.|Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Joe
authors.initials: J
authors.lastname: Verghese
mesh_terms: D000368:Aged; D057565:Apathy; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors