Abstract
Objectives To assess the psychometric attributes of the Apathy Scale- (AS-) Spanish version in patients with advanced Parkinson's disease (APD). Materials and Methods Over 6 months, 61 patients participated in a clinical study of levodopa-carbidopa intestinal gel (LCIG) and were evaluated using the AS and other clinical tools. Various psychometric attributes of the AS were assessed. Results Patients (60.7% men) were aged 68.02 ± 7.43 years, with 12.57 ± 5.97 years from PD diagnosis. Median HY of patients in “on state” was 2 (range, 1–4), and mean levodopa equivalent daily dose was 1455.98 ± 456.00 mg. Overall, the parameters of feasibility/acceptability were satisfactory, except for a moderate-to-high floor effect in AS items but not in its total score (both 3.3%). Cronbach's alpha was 0.78, while item homogeneity coefficient was 0.21. Almost all items (11/14) reached acceptable item-total corrected correlations (rS = 0.16–0.50). AS total score was moderately correlated with Beck Depression Inventory (0.34) and with Non-Motor Symptoms Scale domains 2 (sleep/fatigue, 0.35), 3 (mood/apathy, 0.56), and 5 (attention/memory, 0.41). There were no significant differences between AS total scores by established groups of sex, time from diagnosis, HY, and Clinical Global Impression-Severity Scale. Following LCIG treatment, there was no significant change in the AS total score. The relative change was 5.56%, the standard error of the difference was 4.17, and Cohen's d effect was 0.10. Conclusions The AS showed satisfactory feasibility, acceptability, scaling assumptions, internal consistency, and convergent validity. Responsiveness parameters were poor, probably due to the characteristics of the clinical study from which these data came. This trial is registered with NCT02289729.
Highlights
A syndrome defined by an overall lack of interest and motivation in emotional, cognitive, and goal-directed behavior, [1] is a nonmotor symptom frequently associated with various medical disorders, including Parkinson’s disease (PD)
Apathy has been shown to reduce goal-directed behaviors and emotional reactivity, causing less adherence to Parkinson’s Disease treatments, faster cognitive decline, lower quality of life (QoL), functional impairment, and increased caregiver burden [3, 4]. To accurately assess this burdensome nonmotor symptom in PD, the Apathy Scale (AS) was created [5]. e AS is a 14question inventory that evaluates the domains of apathy related to cognition, motivation, and interest. It has shown satisfactory psychometric properties in PD and has been recommended for screening apathy and evaluating its severity in this context [6]; it has not yet been validated for use in either the advanced PD (APD) population or in the Spanish population. erefore, the objective of this study was to assess the psychometric attributes of the Apathy Scale- (AS-)Spanish version in a sample of Spanish patients with advanced Parkinson’s disease (APD)
Data for the present study are derived from the ADEQUA study, an observational, single-arm, postmarketing, nationwide, multicenter clinical study that was carried out in patients with APD with an indication for levodopa-carbidopa intestinal gel (LCIG) [7]
Summary
To assess the psychometric attributes of the Apathy Scale- (AS-) Spanish version in patients with advanced Parkinson’s disease (APD). Over 6 months, 61 patients participated in a clinical study of levodopa-carbidopa intestinal gel (LCIG) and were evaluated using the AS and other clinical tools. The parameters of feasibility/acceptability were satisfactory, except for a moderate-to-high floor effect in AS items but not in its total score (both 3.3%). AS total score was moderately correlated with Beck Depression Inventory (0.34) and with Non-Motor Symptoms Scale domains 2 (sleep/fatigue, 0.35), 3 (mood/apathy, 0.56), and 5 (attention/memory, 0.41). Ere were no significant differences between AS total scores by established groups of sex, time from diagnosis, HY, and Clinical Global Impression-Severity Scale. Following LCIG treatment, there was no significant change in the AS total score. Responsiveness parameters were poor, probably due to the characteristics of the clinical study from which these data came. is trial is registered with NCT02289729
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