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P3‐559: APATHY IS ASSOCIATED WITH RISK OF INCIDENT DEMENTIA AMONG COMMUNITY‐DWELLING OLDER ADULTS
Author(s) -
Bock Meredith A.,
Kaup Allison R.,
Yaffe Kristine
Publication year - 2019
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2019.06.3596
Subject(s) - apathy , dementia , depression (economics) , medicine , cohort , prospective cohort study , geriatric depression scale , cognitive decline , psychiatry , cohort study , population , gerontology , psychology , cognition , disease , depressive symptoms , environmental health , economics , macroeconomics
Objective: To prospectively evaluate the association between symptoms of apathy and incident dementia in a diverse cohort of community-dwelling adults Background: Apathy is prevalent in all dementia subtypes and may be an important prodromal sign associated with progression to dementia, yet this has not been rigorously investigated in a population-based sample. Design/Methods: We studied 2,023 participants from the Health, Aging, and Body Composition (Health ABC) study, a prospective cohort of community-dwelling white and black older adults. The modified Apathy Evaluation Scale was administered at year 6, our study baseline. Prevalent dementia was excluded and incident dementia was measured through Year 15, determined by dementia medication use, hospital records, or significant decline in global cognition (≥ 1.5 SD race-specific decline on the Modified Mini-Mental State Examination (3MS)). We examined the association between baseline apathy tertile and incident dementia using a logistic regression model. We adjusted the model for age, gender, race, education level, and comorbid depression (measured by the Center for Epidemiologic Studies Depression Scale). We used a linear mixed effects model to evaluate the association between baseline apathy tertile and cognitive decline, as measured by the 3MS and Digit Symbol Substitution Test through year 10. Results: There were 381 (18%) cases of incident dementia over 9 years of follow-up. Severe apathy was associated with risk of incident dementia in unadjusted (OR 1.9, 95% CI 1.5–2.6) and adjusted models (25% vs. 14%, OR 1.5, 95% CI 1.1–2.1). Severity of apathy predicted cognitive scores at the study baseline but not change in cognition over time. Conclusions: In a diverse cohort of community-dwelling adults, apathy was associated with increased risk of developing dementia. A brief assessment of apathy may have clinical utility in risk stratifying the elderly for progression to dementia. Disclosure: Dr. Bock has nothing to disclose. Dr. Xia has nothing to disclose. Dr. Hoang has nothing to disclose. Dr. Yaffe has nothing to disclose.