Apathie bei gerontopsychiatrischen und geriatrischen Patienten: eine Vergleichs- und Verlaufsstudie mittels Aktigraphie

Abstract

OBJECTIVES: Apathy is a common neuropsychiatric symptom and complication in dementia and mild cognitive impairment (MCI). This study examines the correlation between a validated rating scale for apathy, the Apathy Evaluation Scale (AES) and actigraphic measures of daytime activity. The aim of this study is to determine the value of ambulatory actigraphy in the assessment of locomotor deficits as a correlate of apathy in geriatric patients with amnestic MCI and dementia. DESIGN: cross-sectional PARTICIPANTS: A total of 80 participants were recruited, 31 patients with dementia (Alzheimer dementia (AD), mixed dementia (MXD) or frontotemporal dementia (FTD)), 21 patients with MCI and 23 elderly controls without evidence of cognitive deficits. RESEARCH DESIGN: Self- and investigator administered rating scales for apathy (AES) and depression (Beck Depression Inventory, BDI) were completed. To measure daytime activity a wrist-worn actigraph and an established protocol with registration over 5 days and sampling epochs of 10 s were used. All subjects were instructed to protocol their daytime activities and sleeping times in a diary (with or without support from relatives). A single measure of mean daytime activity per participant was calculated for further statistical analysis. RESULTS: In the two groups of patients with MCI and dementia apathy goes along with reduced daytime activity, independent from the diagnosis (no group by apathy interaction). AES scores correlate significantly with daytime activity. Cognitive impairment reduce daytime activity, dementia more than MCI: Daytime activity is negatively correlated with memory deficits. CONCLUSION: Ambulatory actigraphy is a promising method to evaluate self-initiated action as a correlate of apathy in cognitive impaired participants.