RT Journal
A1 Ligthart SA, Richard E, Fransen NL, et al
T1 ASsociation of vascular factors with apathy in community-dwelling elderly individuals
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2012
FD June 1
VO 69
IS 6
SP 636
OP 642
DO 10.1001/archgenpsychiatry.2011.1858
UL http://dx.doi.org/10.1001/archgenpsychiatry.2011.1858
AB Context 
                  Apathy in community-dwelling elderly individuals has been associated with a history of stroke and other cardiovascular disease.Objective 
                  To assess the relationship between symptoms of apathy and cardiovascular risk factors or disease (stroke or other) in a large sample of elderly people aged 70 to 78 years without depression or dementia.Design 
                  Cross-sectional data analysis within an ongoing cluster-randomized, open, multicenter trial.Setting 
                  The Netherlands, general community.Participants 
                  We studied 3534 elderly individuals without dementia who were included in the Prevention of Dementia by Intensive Vascular Care trial.Main Outcome Measures 
                  Symptoms of apathy, assessed with 3 items from the 15-item Geriatric Depression Scale, in participants with few or no depressive symptoms.Results 
                  The median age of participants was 74.3 years. Principal components analysis of the Geriatric Depression Scale confirmed a separate factor for the apathy items (Geriatric Depression Scale–3A). Two or more symptoms of apathy were present in 699 participants (19.9%), of whom 372 (53.2%) were without depressive symptoms (Geriatric Depression Scale–12D score <2). Ordinal regression analysis showed that increasing apathy in the absence of depressive symptoms was associated with a history of stroke (odds ratio, 1.79; 95% CI, 1.38-2.31) and cardiovascular disease other than stroke (1.28; 1.09-1.52). Exploratory analysis among 1889 participants free from stroke and other cardiovascular disease revealed an association between apathy score and the following cardiovascular risk factors: systolic blood pressure (P = .03), body mass index (P = .002), type 2 diabetes mellitus (P = .07), and C-reactive protein (P < .001).Conclusions 
                  Symptoms indicative of apathy are common in community-dwelling nondemented older people who are free from depression. The independent association of stroke, other cardiovascular disease, and cardiovascular risk factors with symptoms of apathy suggests a causal role of vascular factors.Trial Registration 
                  isrctn.org Identifier: ISRCTN29711771