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Apathy is more severe in vascular than amnestic mild cognitive impairment in a community: The K urihara P roject
Author(s) -
Nakamura Kei,
Kasai Mari,
Ouchi Yoshitaka,
Nakatsuka Masahiro,
Tanaka Naofumi,
Kato Yuriko,
Nakai Megumi,
Meguro Kenichi
Publication year - 2013
Publication title -
psychiatry and clinical neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.609
H-Index - 74
eISSN - 1440-1819
pISSN - 1323-1316
DOI - 10.1111/pcn.12098
Subject(s) - apathy , clinical dementia rating , dementia , cognitive impairment , medicine , psychology , vascular dementia , cognition , psychiatry , disease
Aim: The aim of this study was to estimate the prevalence of apathy, and to compare vascular mild cognitive impairment ( vMCI ), amnestic MCI ( amMCI ), and other type using Clinical Assessment for Spontaneity ( CAS ). Methods: Agreement to take part in the study was obtained from 590 community dwellers, aged ≥75 years living in K urihara, J apan. Of the 590 subjects, 221 had a clinical dementia rating ( CDR ) of 0 (normal); 295 had CDR 0.5 (mild cognitive impairment; MCI ); and 74 had CDR 1+ (dementia). The CDR 0.5 subjects were divided into three groups: 55 with vMCI ( E rkinjuntti et al . criteria), 91 with amMCI and 149 with other type. To evaluate the various aspects of apathy, we used the three CAS subscales: clinical interview ( CAS 1), self‐evaluation ( CAS 2), and caregiver assessment ( CAS 3). Three analyses were then performed to determine: (i) the validity of CAS ; (ii) the prevalence rate of apathy in CDR 0 versus CDR 0.5 versus CDR 1+; and (iii) the prevalence rate of apathy in normal versus vMCI versus amMCI versus other type. Results: CAS was validated with the A pathy E valuation S cale. There were significant differences among the three CDR groups in CAS 1, CAS 2 and CAS 3 ( P < 0.001). The prevalence rate of apathy in each CAS in the CDR 1+ group was higher than the CDR 0.5 group, which was higher than the CDR 0 group. There was a significant difference in CAS 3 score between the four groups (the normal and the three subgroups; P < 0.001). Apathy in vMCI was more severe than in the other three groups ( P < 0.05) on CAS 3 score. Conclusions: vMCI subjects have more severe apathy compared with amMCI subjects on caregiver assessment.