Regular Research ArticlesApathy Predicts More Severe Parkinsonism in Alzheimer's Disease
Section snippets
PATIENTS METHODS
The AD group included a consecutive series of 354 outpatients attending the dementia clinic at a tertiary neurology center in Buenos Aires, Argentina, between January 1996 and October 2001 for evaluation and treatment of progressive cognitive decline. Because structured assessments for parkinsonism were started after the study was commenced, 169 of the 354 participants were assessed for the present study. All patients met the following inclusion criteria: 1) National Institute of Neurological
RESULTS
Eighty-two patients had no apathy at either baseline or follow-up, 29 patients had apathy at both time points, 21 patients with no apathy at baseline developed apathy at follow-up, and four patients had apathy at baseline but no apathy at follow-up (due to its small size, this group was excluded from further comparisons).
DISCUSSION
We examined the association between apathy and parkinsonism in a 1–4 year follow-up study that included a series of 132 patients with probable AD. We found that patients with apathy at baseline or patients who developed apathy during the follow-up period had a significant increase in parkinsonism than patients who never developed apathy. On the other hand, neither the severity of parkinsonism nor the presence of depression at baseline was related to the severity of apathy at follow-up. Taken
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2016, American Journal of Geriatric PsychiatryCitation Excerpt :In mild cognitive impairment, apathy is associated with higher risk of conversion into dementia. In AD, apathy is related with earlier institutionalization,13 with an increased risk of developing more severe parkinsonism,14 a faster cognitive decline,15 and a higher use of psychotropic drugs.16 In addition, apathy in AD or other dementias is generally accompanied by greater caregiver burden and distress.17,18
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2016, Bioorganic and Medicinal ChemistryCitation Excerpt :Thus, the long-acting partial β2-agonist salmeterol significantly reduced neurotoxic effects by inhibition of microglia-mediated inflammatory responses in mouse models of Parkinson‘s disease.9 Furthermore, β2-agonists have been shown to prevent neuronal cell death in a rat model of traumatic brain injury37 and in a murine model of amyotrophic lateral sclerosis.38 These studies and, in particular, the notable neuroprotective effect of the partial β2-agonist salmeterol suggest that the dual acting test compound (R)-3, exhibiting a potent sub-maximal β2-activation profile similar to salmeterol,39 might provide a useful strategy for the treatment of neurological disorders.
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2013, European PsychiatryCitation Excerpt :In summary, both urinary tract infections and fractured neck of femurs have direct negative effects on psychosocial functioning and a negative impact on cognitive-emotional functioning and communication. In agreement with others, we observed an increased risk of epileptic fits and Parkinson's disease in AD [3,34,52]. However, it might have been possible that in some of the cases co-morbidity for AD and Parkinson's disease might have been better diagnosed as dementia of Lewy body type [27].
Apathy: A pathology of goal-directed behaviour. A new concept of the clinic and pathophysiology of apathy
2012, Revue NeurologiqueCitation Excerpt :In mild cognitive impairment, apathy is associated with a risk of conversion into a dementia of Alzheimer-type (Robert et al., 2006b). In dementia of AD, apathy is associated with earlier institutionalisation (Starkstein et al., 2009a), with an increased risk of developing parkinsonism (Starkstein et al., 2009b), a faster cognitive decline (Lechowski et al., 2009; Starkstein et al., 2009b) and an increased use of psychotropic drugs (Benoit et al., 2008). It is also important to note that apathy is present in several psychiatric conditions such as schizophrenia with negative signs (Winograd-Gurvich et al., 2006; Faerden et al., 2010; Simon et al., 2010) and in adults presenting with attention deficit — hyperactivity disorders (Torrente et al., 2011).
Apathy in first episode psychosis patients: A ten year longitudinal follow-up study
2012, Schizophrenia ResearchCitation Excerpt :Apathy is described as a neuropsychiatric symptom associated with dysfunction of the prefrontal cortex and its subcortical connections (Marin et al., 1991b; Stuss and Knight, 2002; Tekin and Cummings, 2002). It is highly prevalent in neuropsychiatric conditions such as Alzheimer's Disease and Parkinson's Disease, in which it has been associated with functional decline (Starkstein et al., 2006), worse course and outcome (Starkstein et al., 2006; 2009), and poor executive functioning (McPherson et al 2002; Pluck and Brown, 2002; Tsoi et al., 2008). Apathy is well documented in psychotic disorders (Browne et al., 2000; Barch, 2008; Messinger et al., 2011).
Psychiatric aspects of nonpsychiatric disorders in older adults
2009, American Journal of Geriatric Psychiatry
The authors thank Drs. Eran Chemerinski, Romina Mizrahi, Janus Kremer, Ricardo Migliorelli, and Laura Garau for data collection. This work was supported, in part, by a grant from the National Health and Medical Research Council.