Higher Apathy Research Articles

THE CONTRIBUTION OF NIGROSTRIATAL DOPAMINERGIC TRANSMISSION ON APATHY IN OLDER ADULTS

Abstract Apathy is a common and impairing symptom in neurological disorders and its connection with striatal dopamine levels has been examined in Parkinson’s and Alzheimer’s disease. Little is known about the nature of this relationship in older adults free from neurological diseases. This study explores the link between apathy and nigrostriatal dopaminergic neurotransmission in community-dwelling older adults without overt neurological symptoms. This was a cross-sectional study of community-dwelling older adults (N=230, mean age 75.3yrs; 60% female) from Monongahela-Youghiogheny Healthy Aging Team (MYHAT) and Study of Muscle, Mobility and Aging (SOMMA) studies. The nigrostriatal dopamine binding site density of VMAT2 was quantified via (+)-[11C]DTBZ PET imaging. Apathy was assessed with Apathy Evaluation Scale, an 18-item questionnaire using a 4-point Likert scale (range 18-72; higher score indicates greater apathy). Latent class analysis was used to identify latent subtypes of apathy. Multinomial logistic regression was used to investigate the relationship between dopaminergic transmission and latent classes. Three latent classes were identified, namely, low apathy (mean 20.7; SD 2.36; N=110), moderate apathy (mean 25.5; SD 2.83; N=89), and high apathy (mean 32; SD 4.82; N=31). Each SD decrement in nigrostriatal dopaminergic transmission corresponded to 39% and 42% lower odds of having high apathy compared to low apathy (OR=0.61; 95%CI: 0.39-0.95; p-value=0.028) and moderate apathy (OR=0.58; 95%CI: 0.36-0.90; p-value=0.015), respectively, after adjusting for age at the time of MRPET scan, gender, and race. Our study highlights apathy’s inverse relationship with dopaminergic neurotransmission, which underscores the importance of considering dopaminergic pathways in managing apathy in older adults.

Apathy, Intentions, Explicit Attitudes, and Approach-Avoidance Tendencies in Physical Activity Behavior

Background. Greater behavioral apathy has been shown to be associated with lower engagement in physical activity. However, the mechanisms underlying this association remain overlooked and poorly understood. Intentions, explicit attitudes, and approach-avoidance tendencies toward physical activity may play a central role in the relationship, given their strong links to motivation and physical activity. Methods. An online study was conducted in 365 participants aged 54±18 years. All measures were assessed using questionnaires, except approach-avoidance tendencies, which were derived from reaction times in an approach-avoidance task. Component mediation analyses based on multiple linear regressions were conducted to examine whether the intention to be physically active mediated the relationship between behavioral apathy levels and usual physical activity levels, and whether explicit attitudes and approach-avoidance tendencies mediated the relationship between behavioral apathy and the intention. Results. Results showed that weaker intentions to be physically active mediated the association between higher behavioral apathy and lower usual weekly levels of moderate-to-vigorous physical activity. In addition, explicit attitudes mediated the effect of behavioral apathy on intentions to be physically active. Results on approach-avoidance tendencies showed a significant three-way interaction between apathy, stimulus (physical activity vs. sedentary behavior), and action direction (approach vs. avoidance) on corrected reaction time (b = 19.6; 95CI = 2.0 to 37.3; p = .029), with higher apathy being associated with a greater tendency to avoid physical activity stimuli and to approach sedentary stimuli. However, we found no evidence suggesting that these tendencies mediated the effect of apathy on intentions or habitual physical activity. Based on our data, a mean item score greater than 34.5% of the scale range (e.g., >3.07 on a 1–7 scale) is indicative of behavioral apathy. Conclusion. This study provides new insights into the role of intentions, explicit attitudes, and approach-avoidance tendencies toward physical activity in the relationship between behavioral apathy levels and the engagement in physical activity.

Apathy and effort-based decision-making in Alzheimer's disease and subjective cognitive impairment.

Apathy is a significant feature in Alzheimer's disease (AD) and subjective cognitive impairment (SCI), though its mechanisms are not well established. An effort-based decision-making (EBDM) framework was applied to investigate apathy in 30 AD patients, 41 SCI participants, and 55 healthy controls (HC). Data were analyzed using a drift-diffusion model (DDM) to uncover latent psychological processes. SCI participants reported higher apathy than AD patients and HC. However, informant reports of apathy in AD patients were higher than self-reports and indicated significant apathy compared to HC. Both the AD and SCI groups showed reduced sensitivity to effort changes, linked to executive dysfunction in AD and apathy in SCI. Increased resting functional cortical connectivity with the nucleus accumbens (NA) was associated with higher apathy in SCI. These results highlight a similar disruption of EBDM in AD and SCI, differentially related to executive functioning in AD and apathy in SCI. This is the first study investigating apathy using an effort-based decision-making (EBDM) framework in Alzheimer's disease (AD) and subjective cognitive impairment (SCI).Self-reports underestimate apathy in AD patients when compared to informant reports and healthy controls (HC). SCI participants, in whom self and informant reports were more concordant, also showed higher degrees of apathy.Both AD and SCI groups showed reduced sensitivity to effort.Reduced sensitivity to effort correlates with executive dysfunction in AD and apathy, but not depression, in SCI.Increased nucleus accumbens (ventral striatum) connectivity with the frontoparietal network was associated with higher apathy scores in SCI.The results thus suggest that while AD and SCI can have similar deficits in EBDM, these deficits correlate with distinct clinical manifestations: executive dysfunction in AD and apathy in SCI.

Atrophy network mapping of clinical subtypes and main symptoms in frontotemporal dementia.

Frontotemporal dementia (FTD) is a disease of high heterogeneity, apathy and disinhibition present in all subtypes of FTD and imposes a significant burden on families/society. Traditional neuroimaging analysis has limitations in elucidating the network localization due to individual clinical and neuroanatomical variability. The study aims to identify the atrophy network map associated with different FTD clinical subtypes and determine the specific localization of the network for apathy and disinhibition. Eighty FTD patients [45 behavioural variant FTD (bvFTD) and 35 semantic variant progressive primary aphasia (svPPA)] and 58 healthy controls at Xuanwu Hospital were enrolled as Dataset 1; 112 FTD patients including 50 bvFTD, 32 svPPA and 30 non-fluent variant PPA (nfvPPA) cases, and 110 healthy controls from the Frontotemporal Lobar Degeneration Neuroimaging Initiative (FTLDNI) dataset were included as Dataset 2. Initially, single-subject atrophy maps were defined by comparing cortical thickness in each FTD patient versus healthy controls. Next, the network of brain regions functionally connected to each FTD patient's location of atrophy was determined using seed-based functional connectivity in a large (n = 1000) normative connectome. Finally, we used atrophy network mapping to define clinical subtype-specific network (45 bvFTD, 35 svPPA and 58 healthy controls in Dataset 1; 50 bvFTD, 32 svPPA, 30 nfvPPA and 110 healthy controls in Dataset 2) and symptom-specific networks [combined Datasets 1 and 2, apathy without depression versus non-apathy without depression (80:26), disinhibition versus non-disinhibition (88:68)]. We compare the result with matched symptom networks derived from patients with focal brain lesions or conjunction analysis. Through the analysis of two datasets, we identified heterogeneity in atrophy patterns among FTD patients. However, these atrophy patterns are connected to a common brain network. The primary regions affected by atrophy in FTD included the frontal and temporal lobes, particularly the anterior temporal lobe. bvFTD connects to frontal and temporal cortical areas, svPPA mainly impacts the anterior temporal region and nfvPPA targets the inferior frontal gyrus and precentral cortex regions. The apathy-specific network was localized in the orbital frontal cortex and ventral striatum, while the disinhibition-specific network was localized in the bilateral orbital frontal gyrus and right temporal lobe. Apathy and disinhibition atrophy networks resemble known motivational and criminal lesion networks, respectively. A significant correlation was found between the apathy/disinhibition scores and functional connectivity between atrophy maps and the peak of the networks. This study localizes the common network of clinical subtypes and main symptoms in FTD, guiding future FTD neuromodulation interventions.

VOTERS APATHY IN DEMOCRATIC PROCESS OF ONDO STATE NIGERIA: INTERROGATING THE 2020 GOVERNORSHIP ELECTION

Voters’ participation in election is essential for deciding leadership legitimacy in a democracy in any part of the globe. However, voters’ participation in Nigeria has continued to dwindle, may be due to failure of government and political elites to address social, political, economic and security challenges confronting the nation which Ondo state is not an exception. Existing literature showed that scholars has provide insights into voters’ apathy towards elections but did not comprehensively measured the extent of opinion about factors that influenced voters’ apathy in 2023 governorship election in ondo state Nigeria, underlining the need to reassess the issue. This study therefore assessed the factors that influenced voter apathy in 2020 governorship election in ondo state Nigeria and show extent of opinions. This study is rooted in rational choice theory. Both primary and secondary methods were adopted to gather data. This study found only 27% of registered voters participated in 2020 Ondo state’s Gubernatorial election indicating high apathy and questioning the election's legitimacy. It reveals extent which some factors such as age, education, tribe, political violence, lack of accountability, bad governance, and insufficient election information has influenced apathy was high, while health status, security and monetary inducements were less influential. To address voter apathy, it recommends engaging all age groups, increasing voter education, promoting inclusive policies, improving healthcare, security, strengthening political accountability, enhancing information dissemination and tackling financial barriers to foster higher voters’ participation and stronger democracy in Ondo State, Nigeria.

Speech markers of depression dimensions across the spectrum of cognitive functions

AbstractBackgroundDepression is a common among patients with cognitive impairment and encompass different dimensions, which may vary in their association with cognitive outcomes and biological substrates. Previous studies have shown a shift toward the use of more negative words in written documents and social media posts of depressed patients with intact cognitive function. To objectively characterize depression dimensions across the spectrum of cognitive functions, we explored their association with the emotion‐based measures of speech in participants of memory clinic.MethodsThis study capitalized on semi‐structured digitized speech data collected at the hospital of University of Pennsylvania. Subjects (n = 302, 40% female, mean age = 67.13±9.59 years, education = 15.82±2.84 years, Mini‐Mental Status Exam (MMSE) = 24.36±5.04) were native English speakers with cognition ranging from normal cognition to mild dementia. Participants were instructed to describe the Cookie Theft scene using complete sentences and their descriptions were digitally recorded. Emotion‐based measures of the content words, including valence (i.e., the pleasantness), arousal (the intensity of emotions), and dominance (the word power), were rated based on published norms. Each emotional measure was averaged per speaker. Depression dimensions were defined based on itemized Geriatric Depression Scale – 15 item (GDS‐15) including Dysphoria, Withdrawal‐Apathy–Vigor (WAV), anxiety, hopelessness and Subjective Memory Complaint. Non‐parametric partial correlations examined associations between speech emotion‐based measures and depression scores adjusting for age, sex, education and MMSE.ResultsOverall depression score (total GDS) did not correlate with the speech measures. However, when examining specific depression dimensions, higher WAV and hopelessness correlated with reduced valence (WAV: r = ‐0.21, P = 0.00, hopelessness: r = ‐ 0.14, P = 0.01) and dominance (WAV: r = ‐ 0.18, P = 0.001, hopelessness: r = ‐ 0.16, P = 0.004). We did not find a significant association between emotional word scores and other depression dimensions.ConclusionPatients with high apathy and hopelessness select words that carry more negative and less powerful emotional valence. Our findings highlight the potential applicability of speech biomarkers in characterization of depression dimensions across spectrum of cognitive and are consistent with previous findings that reported more negative bias and more submissive speech in depressed patients.

Digital technology and democracy in Nigeria: a study of how technology is transforming elections without necessarily deepening democracy

ABSTRACT This article examines the role of digital technologies in deepening democracy in Nigeria. It argues that though technologies have considerably improved the transparency and credibility of electoral processes in Nigeria, democracy remains stunted and weak. Elections have been marred by high voter apathy and low voter turnout. Vote buying has emerged to replace old forms of electoral malpractices such as ballot stuffing, result sheet manipulations, multiple voting and hijacking of ballot boxes. Furthermore, many elections in which technologies were used still end up being seriously disputed. The article concludes that deepening democracy requires much more than improving the credibility of electoral processes. Mature democracies are characterised by popular participation, equality of votes and effective representation. Other essential components include an independent electoral umpire, a sound legal framework and the rule of law.

The neuropsychology of healthy aging: the positive context of the University of the Third Age during the COVID-19 pandemic

Older adults have been reported to have increased susceptibility to the adverse effects of SARS-CoV-2 infection, such as fatal outcomes, cognitive decline, and changes in physical and/or mental health. However, few studies have examined neuropsychological changes by comparing measurements before and during the pandemic in healthy older people. In addition, no longitudinal studies have examined whether older adults may have responded positively to the pandemic. We examined these issues through a 2-year neuropsychological study before and during the pandemic period. Results showed that scores before and during the pandemic were the same in memory and attention, whereas global cognitive, executive, and language functions improved. Participants also showed no longitudinal changes in depression, hypomania, and disinhibition, while apathy and, to a lesser extent, anxiety increased significantly. To examine possible signs of pandemic-related emotional (dys)regulation, subjects were shown images at follow-up that recalled the most dramatic lockdown phase while heart rate variability was recorded. Higher apathy was predicted by poorer global cognitive performance, increased anxiety, and emotional dysregulation as measured by a higher ratio of low-to-high frequency heart rate variability. Thus, preserved global cognition appears to play a protective role against the effects of pandemic-related anxiety and emotional dysregulation on apathy.

Association of Apathy with Amyloid‐β and Tau in Cognitively Unimpaired Older Adults: Findings from the Harvard Aging Brain Study

AbstractBackgroundApathy is one the most common neuropsychiatric symptoms (NPS) in Alzheimer’s disease (AD) and is associated with elevated AD pathology in cognitively impaired individuals. However, it remains unclear if apathy is associated with AD pathology, specifically amyloid‐β and tau, in cognitively unimpaired (CU) older adults. Therefore, we examined cross‐sectional relationships between apathy and neuroimaging AD biomarkers in CU older adults from the Harvard Aging Brain Study (HABS).MethodHABS is a prospective cohort study that enrolled CU older adults. A random subset of HABS participants (n = 142, age: 80.53 ±6.0, 57% female) and their study partners (SP) completed the Apathy Evaluation Scale‐Self (AES‐S) and ‐Informant (AES‐I). The AES consists of 18 items rated on a 4‐point Likert‐type scale; lower scores indicate greater apathy. We used Pittsburgh Compound B (PiB) PET cortical composite distribution volume ratio to measure amyloid‐β (Aβ), and flortaucipir (FTP) PET standardized uptake value ratio in two regions (bilateral entorhinal (ER) cortex and inferior temporal (IT) cortex) to capture regional tau. We assessed the association of AES‐S or AES‐I (dependent variable) with Aβ, or each of the two regional tau values (independent variable), in linear models adjusting for age, sex, and education. We then explored Aβ‐independent associations between regional tau and AES‐I/AES‐S, by additionally adjusting for Aβ in each tau model.ResultElevated Aβ (β = ‐3.7, p = 0.015) and ER Tau (β = ‐6.0, p = 0.016) were associated with lower AES‐I, while IT tau was not (p = 0.14). None of the AD pathology measures were associated with AES‐S (all; p>0.23). ER tau was no longer associated with AES‐I once Aβ was also adjusted for in the model (β = ‐4.4, p = 0.100).ConclusionGreater Aβ and tau levels were associated with higher apathy in CU older adults. Our findings imply that even in CU older adults, apathy is closely related to AD pathology may be more accurately measured by study partner report than self‐report, which may reflect a measurement property of this NPS. Further study of apathy in preclinical stages is needed to provide understanding of potential interventions to prevent or delay behavioral symptoms of AD.

Altered reward processing underpins emotional apathy in dementia

IntroductionWhile apathy is broadly defined as a loss of motivation, it is increasingly recognised as a multidimensional syndrome spanning executive, emotional, and initiation domains. Emotional apathy is purportedly driven by deficits in using socioemotional rewards to guide behaviour, yet the link between these symptoms and reward processing, and their common neural correlates, has not been directly examined.MethodsSixty-four patients (33 behavioural-variant frontotemporal dementia, 14 Alzheimer’s disease, 8 semantic dementia, 6 progressive nonfluent aphasia, 3 logopenic progressive aphasia) were classified into high (HEA; n = 36) and low (LEA; n = 28) emotional apathy groups based on emotional apathy subscale scores on the Dimensional Apathy Scale. Patients and age-matched healthy controls (n = 27) performed an instrumental reward learning task where they learned to associate cues with either social or monetary outcomes.ResultsHEA patients showed impaired learning on both the social and monetary reward conditions, relative to LEA patients (p = 0.016) and controls (p = 0.005). Conversely, the LEA group did not differ from controls (p = 0.925). Importantly, multiple regression analyses indicated that social reward learning significantly predicted emotional apathy. Voxel-based morphometry analyses revealed that emotional apathy and social reward learning were both associated with orbitofrontal cortex, ventral striatum, and insula atrophy.DiscussionOur results demonstrate a unique link between impaired social reward learning and emotional apathy in dementia and reveal a shared neurobiological basis. Greater understanding of these neurocognitive mechanisms of reward processing will help improve the identification of emotional apathy in dementia and inform the development of novel interventions to address these symptoms.

Disentangling Clinical Profiles of Apathy in Behavioral Variant Frontotemporal Dementia.

Apathy is highly frequent in behavioral variant frontotemporal dementia (bvFTD). It is presumed to involve different pathophysiological mechanisms and neuroanatomical regions. We explored the hypothesis that subgroups showing distinct profiles of apathy and distinct patterns of atrophy within frontal lobes could be disentangled in bvFTD. Using data-driven clustering applied to 20 bvFTD patients, we isolated subgroups according to their profiles on the three subscales of the Dimensional Apathy Scale (DAS). We explored their apathy profiles and atrophy patterns. Apathy profiles were characterized through both subjective measures of apathy by questionnaires and measures including objective behavioral metrics. Atrophy patterns were obtained by voxel-based morphometry, contrasting each bvFTD subgroup with healthy controls (N = 16). By clustering based on DAS dimensions, we disentangled three subgroups of bvFTD patients, with distinct apathy profiles and atrophy patterns. One subgroup, which presented the smallest pattern of atrophy (including orbitofrontal cortex) with a right asymmetry, was characterized by high self-reported emotional and initiation apathy and by a self-initiation deficit reversible by external guidance. In other subgroups showing more diffuse bilateral atrophies extending to lateral prefrontal cortex, apathy was not reversible by external guidance and more difficulty to focus on goal-management was observed, especially in the subgroup with the largest atrophy and highest levels of executive apathy. Distinct clinical profiles of apathy, corresponding to distinct anatomical subtypes of bvFTD, were identified. These findings have implications for clinicians in a perspective of precision medicine as they could contribute to personalize treatments of apathy.

Role of the amygdala in disrupted integration and effective connectivity of cortico-subcortical networks in apathy.

Apathy is a quantitative reduction in motivation and goal-directed behaviors, not only observed in neuropsychiatric disorders, but also present in healthy populations. Although brain abnormalities associated with apathy in clinical disorders have been studied, the organization of brain networks in healthy individuals has yet to be identified. We examined properties of intrinsic brain networks in healthy individuals with varied levels of apathy. By using functional magnetic resonance imaging in combination with graph theory analysis and dynamic causal modeling analysis, we tested communications among nodes and modules as well as effective connectivity among brain networks. We found that the average participation coefficient of the subcortical network, especially the amygdala, was lower in individuals with high than low apathy. Importantly, we observed weaker effective connectivity fromthe hippocampus and parahippocampal gyrus to the amygdala, and from the amygdala to the parahippocampal gyrus and medial frontal cortex in individuals with apathy. These findings suggest that individuals with high apathy exhibit aberrant communication within the cortical-to-subcortical network, characterized by differences in amygdala-related effective connectivity. Our work sheds light on the neural basis of apathy in subclinical populations and may have implications for understanding the development of clinical conditions that feature apathy.

Locus Coeruleus Integrity from 7 T MRI Relates to Apathy and Cognition in Parkinsonian Disorders.

BackgroundNeurodegeneration in the locus coeruleus (LC) contributes to neuropsychiatric symptoms in both Parkinson's disease (PD) and progressive supranuclear palsy (PSP). Spatial precision of LC imaging is improved with ultrahigh field 7 T magnetic resonance imaging.ObjectivesThis study aimed to characterize the spatial patterns of LC pathological change in PD and PSP and the transdiagnostic relationship between LC signals and neuropsychiatric symptoms.MethodsTwenty‐five people with idiopathic PD, 14 people with probable PSP‐Richardson's syndrome, and 24 age‐matched healthy controls were recruited. Participants underwent clinical assessments and high‐resolution (0.08 mm3) 7 T‐magnetization‐transfer imaging to measure LC integrity in vivo. Spatial patterns of LC change were obtained using subregional mean contrast ratios and significant LC clusters; we further correlated the LC contrast with measures of apathy and cognition, using both mixed‐effect models and voxelwise analyses.ResultsPSP and PD groups showed significant LC degeneration in the caudal subregion relative to controls. Mixed‐effect models revealed a significant interaction between disease‐group and apathy‐related correlations with LC degeneration (β = 0.46, SE [standard error] = 0.17, F(1, 35) = 7.46, P = 0.01), driven by a strong correlation in PSP (β = −0.58, SE = 0.21, t(35) = −2.76, P = 0.009). Across both disease groups, voxelwise analyses indicated that lower LC integrity was associated with worse cognition and higher apathy scores.ConclusionsThe relationship between LC and nonmotor symptoms highlights a role for noradrenergic dysfunction across both PD and PSP, confirming the potential for noradrenergic therapeutic strategies to address transdiagnostic cognitive and behavioral features in neurodegenerative disease. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

TaPiscine: An effort‐based decision‐making task for apathy assessment in people with neurocognitive disorders

AbstractBackgroundApathy is a common neuropsychiatric symptom in Neurocognitive Disorders (NCD). It is characterized by a significant reduction of goal‐directed behaviors in the domains of cognition, behavior, emotions, and social interactions. Goal‐directed behaviors can be investigated using effort‐based decision paradigms, allowing computational models to quantify sensitivity to effort and reward (and their combination) in a systematic way [1]. Our study used an effort‐based decision paradigm to investigate apathetic symptoms in a clinical context with older people with NCD and subjective cognitive decline (SCD).MethodWe recruited 33 participants with mild NCD or SCD from the Memory Center in Nice (24 females, mean age= 74 years, mean MMSE score = 27.1). We assessed self‐reported apathy using the Apathy Motivation Index (AMI) and the Dimensional Apathy Scale (DAS). We also assessed self‐reported fatigue (Multidimensional Fatigue Inventory, MFI), anhedonia (Snaith‐Hamilton Pleasure Scale, SHAPS), and depression (Geriatric Depression Scale, GDS). The effort‐based decision task consisted of choosing to perform an action (taping as quickly as possible on a tactile tablet to fill a virtual pool corresponding to 25%, 50%, 75% and 100% of the maximum individual effort) to obtain a specific reward (3, 6 or 9 credits to discover pictures), or to rest to ensure 1 credit. For each subject, we extracted a parameter (K) representing the degree to which a reward is devalued by effort.ResultsWe divided participants into two groups with high and low AMI scores using a mean split. Results suggested that the K‐parameter was almost significantly lower in subjects with higher apathy (U=86, p=0,072). Further and more detailed analyses will be performed once reached a sample size of 50 subjects (end of June 2021).ConclusionsEffort‐based decision tasks may be employed also in people with NCD, and may help to differentiate patients with low and high apathy. The study is ongoing, and a bigger sample will allow to better characterize these results. Reference: [1] Lockwood, P., Hamonet, M., Zhang, S. et al. Prosocial apathy for helping others when effort is required. Nat Hum Behav. 1, 0131 (2017). https://doi.org/10.1038/s41562‐017‐0131

Different Associated Factors of Subjective Cognitive Complaints in Patients With Early- and Late-Onset Parkinson's Disease.

Background: Subjective cognitive complaints (SCCs), which are associated with a higher risk of cognitive decline, are widespread in the patients with Parkinson's disease (PD). The previous studies have reported inconsistent factors related to SCCs in the patients with late-onset PD (LOPD), and there is limited information on SCCs in the patients with early-onset PD (EOPD).Objective: We aimed to investigate the factors associated with SCCs in the drug-naïve patients with EOPD and LOPD without cognitive impairment.Methods: This cross-sectional study included 332 drug-naïve patients with PD, among whom 134 were EOPD and 198 were LOPD. Motor and non-motor symptoms, such as global objective cognitive status, depression, anxiety, apathy, fatigue, sleep, rapid eye movement sleep behavior disorder, orthostatic hypotension, and excessive daytime sleepiness, were assessed.Results: Twenty-five (18.66%) patients with EOPD and 49 (24.74%) patients with LOPD reported SCCs. A multivariate binary logistic regression analysis revealed that older age at onset [odds ratio (OR) = 1.24, P = 0.002], higher apathy score (OR = 1.13, P = 0.003), and lower scores in the visuospatial/executive abilities (OR = 0.25, P < 0.001) and memory (OR = 0.50, P = 0.024) domains of the Montreal Cognitive Assessment were associated with a higher risk of SCCs in the EOPD group. Higher apathy (OR = 1.06, P = 0.011) and anxiety (OR = 1.14, P < 0.001) scores were associated with SCCs in the LOPD group.Conclusion: Subjective cognitive complaints are only associated with mood disorders in patients with LOPD. In addition, SCCs may reflect subthreshold cognitive impairment in the patients with EOPD.

Confirmatory Factor Analysis of the Geriatric Depression Scale to Measure Apathy in Older Adults

Apathy is a psychological syndrome characterized by lack of motivation, interest, flattening of affect and social withdrawal; which has been associated with cognitive and functional decline in community dwelling older adults. Many of these associations have been investigated using subscales of depression tools, with varying sensitivity and specificity. The objective of this study was to develop an apathy measurement model, which distinguishes depression and apathy, using the Geriatric Depression Scale Long Form (GDS). We conducted an exploratory factor analysis (EFA) in a memory clinic cohort (N=81) who completed the GDS. Based on the EFA results, we ran a confirmatory factor analysis (CFA) in a community dwelling cohort of older adults (≥65 years old) enrolled in the Central Control of Mobility in Aging study (CCMA) and computed factor scores in both cohorts. CFA of the GDS in the CCMA cohort (N=538) yielded 3 factors: Depression (14 items; Cronbach’s α=0.77), Apathy (10 items; Cronbach’s α=0.63), and Cognitive concern (4 items; Cronbach’s α=0.546). In linear regression models, adjusted for age and gender, the memory clinic cohort had significantly higher Apathy factor scores (β = .18, t(618) = 4.49, p < .001) factor scores compared to the CCMA cohort.Our findings suggest that the CFA derived apathy score is a reliable and valid tool to distinguish apathy from depression in older adults. This novel measurement model can be employed in both clinic and research populations to investigate the role of apathy in cognitive decline.

The Efficacy of Sertraline, Escitalopram, and Nicergoline in the Treatment of Depression and Apathy in Alzheimer's Disease: The Okayama Depression and Apathy Project (ODAP).

Neuropsychiatric symptoms of dementia such as depression and apathy in patients with Alzheimer's disease (AD) are associated with a lower quality of life. We aimed to determine the efficacy of two antidepressants and one antipathy drug in the treatment of depression and apathy in AD patients. In the present study, we evaluated the efficacy of sertraline (n = 11; average dose = 31.8 mg), escitalopram (n = 13; average dose = 7.3 mg), and nicergoline (n = 9; average dose = 14.5 mg) in treating depression and apathy over a period of 3 months (M).The 33 patients with AD demonstrated high Geriatric Depression Scale (GDS) (>5) or a high Apathy Scale (AS) (>16) scores. The patients receiving escitalopram treatment showed a significant improvement in GDS score from baseline (8.2±3.5) to 3 M (5.7±2.6, p = 0.04), and the patients receiving sertraline treatment showed a significant improvement in AS score from baseline (20.8±5.2) to 3 M (16.8±6.1, p = 0.05); however, no significant changes were noted in patients receiving nicergoline. These results provide novel information on the efficacy of sertraline and escitalopram in the treatment of apathy and depression, respectively, in patients with AD.

Trajectory and early predictors of apathy development in first-episode psychosis and healthy controls: a 10-year follow-up study

Apathy is prevalent in first-episode psychosis (FEP) and associated with reduced global functioning. Investigations of the trajectory of apathy and its early predictors are needed to develop new treatment interventions. We here measured the levels of apathy over the first 10 years of treatment in FEP and in healthy controls (HC). We recruited 198 HC and 198 FEP participants. We measured apathy with the Apathy Evaluation Scale, self-report version, psychotic symptoms with the Positive and Negative Syndrome Scale, depression with the Calgary Depression Scale for Schizophrenia, functioning with the Global Assessment of Functioning Scale, and also estimated the duration of untreated psychosis (DUP). The longitudinal development of apathy and its predictors were explored using linear mixed models analyses. Associations to functioning at 10 years were investigated using multiple hierarchical linear regression analyses. In HC, mean apathy levels were low and stable. In FEP, apathy levels decreased significantly during the first year of treatment, followed by long-term stability. High individual levels of apathy at baseline were associated with higher apathy levels during the follow-up. Long DUP and high baseline levels of depression predicted higher apathy levels at follow-ups. The effect of DUP was persistent, while the effect of baseline depression decreased over time. At 10 years, apathy was statistically significantly associated with reduced functioning. The early phase of the disorder may be critical to the development of apathy in FEP.

Spontaneous emergence of a third position in an opinion formation model

Abstract Opinion dynamics is one of the most studied problems in sociophysics. Many easy-to-analyze dynamical systems are modeled in a language of agent-based numerical procedures in order to provide new insights for understanding collective phenomena. The present work is devoted to analyze the effects of spatial heterogeneities in the initial topological map of agent ideas. In the spirit of the statistical physics of social impact, we study the consequences of running a Sznajd model into a structured opinion formation dynamics of a given social community. We carry out a spatio-temporal fractal analysis of the ideological configuration map, showing novel features belonging to different initial conditions. By performing numerical simulations, we mainly show how the evolution of ideas can lead to a spontaneous emergence of a third ideological position. This emergence is just characterized by few parameters: the dimensionality of the initial ideological structures and the interaction dynamics. No additional external constraints are assumed. Moreover, different emergent behaviors in the limit of high participation apathy are observed.

Tau-induced focal neurotoxicity and network disruption related to apathy in Alzheimer’s disease

ObjectiveApathy is a common neuropsychological symptom in Alzheimer’s disease (AD), and previous studies demonstrated that neuronal loss and network disruption in some brain regions play pivotal roles in the pathogenesis...