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Delineation of Apathy Subgroups in Parkinson's Disease: Differences in Clinical Presentation, Functional Ability, Health‐related Quality of Life, and Caregiver Burden
Author(s) -
Eglit Graham M.L.,
Lopez Francesca,
Schiehser Dawn M.,
PirogovskyTurk Eva,
Litvan Irene,
Lessig Stephanie,
Filoteo J. Vincent
Publication year - 2021
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.13127
Subject(s) - apathy , quality of life (healthcare) , parkinson's disease , presentation (obstetrics) , disease , caregiver burden , medicine , health related quality of life , psychology , gerontology , psychiatry , psychotherapist , dementia , radiology
Background Apathy is a prevalent, multidimensional neuropsychiatric condition in Parkinson's disease (PD). Several authors have proposed apathy subtypes in PD, but no study has examined the classification of PD patients into distinct apathy subtypes, nor has any study examined the clinical utility of doing so. Objectives The current study used a data‐driven approach to explore the existence and associated clinical characteristics of apathy subtypes in PD. Method The Apathy Scale (AS) was administered to 157 non‐demented individuals with PD. Participants were classified into apathy subgroups through cluster analysis. Differences among apathy subtypes on external clinical indicators were explored across apathy subgroups. Results Individuals with PD were classified into three subgroups: a Non‐Apathetic group with low levels of apathy symptoms, a Low Interest/Energy group, characterized by elevated symptoms of low interest/energy and minimal low initiation/emotional indifference symptoms, and a Low Initiation group, characterized by an absence of low interest/energy symptoms and elevated levels of low initiation/emotional indifference symptoms. Both Low Interest/Energy and Low Initiation groups exhibited worse depression, fatigue, anxiety, health‐related quality of life, and caregiver burden than the Non‐Apathetic subgroup. The Low Initiation group exhibited worse overall cognition, emotional well‐being, state anxiety, communicative ability, and functional ability than the Low Interest/Energy group. Importantly, disease‐related characteristics did not differ across apathy symptom subgroups. Conclusions Non‐demented PD patients can be separated into distinct apathy symptom subgroups, which are differentially associated with important clinical variables. Apathy subgroup membership may reflect disruption to different neural systems independent of disease progression.