Apathy in patients with parkinson disease as a function of side of onset

Erica Harris, Patrick McNamara, Raymon Durso

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: In previous studies among patients with Parkinson disease (PD) who were administered the Apathy Evaluation Scale (AES), between 12% and 51% evidenced clinically significant apathy. Although apathy is a risk factor for dementia, its causes and clinical correlates have not been adequately studied. In particular, side of onset of disease, though a likely predictor of apathy and dementia, has not been thoroughly investigated. Methods: A total of 30 mid-stage patients with PD and 35 community-dwelling elderly control patients (CPs) were administered the AES (self version) along with a battery of cognitive and neuropsy-chiatric assessments. Persons close to patients with PD and CPs completed the AES-other (informant) version about the patient or CP. Multiple linear regression analysis examined predictors of apathy severity after controlling for mood, levodopa dosage equivalents (LDEs), gender, age, and disease severity (Hoehn-Yahr [H-Y] stage). Results: Patients with right-onset disease more frequently exhibited apathy and evidenced significantly higher total AES scores than left-onset patients with PD or CPs (P < .03). Of all the patients, 42% with right-onset PD versus 11.1% of the patients with left-onset PD exhibited clinically significant levels of apathy. There were no differences for self versus informant scores for right-onset patients with PD. The AES scores were not correlated with depression, stress, anxiety, LDEs, gender, age, and H-Y stage. There were no gender differences for any AES variables. Conclusion: Clinically significant levels of apathy are much more likely to occur in patients with right-onset disease. These patients may be at greater risk of PD-related dementia.

Original languageEnglish (US)
Pages (from-to)95-104
Number of pages10
JournalJournal of Geriatric Psychiatry and Neurology
Volume26
Issue number2
DOIs
StatePublished - Jun 2013
Externally publishedYes

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Institute on Deafness and Other Communication Disorders. Competing Interests. There are no competing interests among any of the authors, financial or otherwise.

Funding Information:
Both the Boston University Medical Center (BUMC) and Boston Veterans Affairs Medical Center (VAMC) institutional review boards approved this study. Some material contained within this manuscript was previously published in Harris, E. Neurocognition and self-regulation of the agentic self in patients with Parkinson’s disease (Doctoral dissertation). Boston University, Boston, MA; 2011. Dr Harris owns the copyright to this material. This study is based upon work supported, in part, by the Office of Research and Development, Medical Research Service, Department of Veterans Affairs.

Keywords

  • Apathy
  • Dementia
  • Dopamine
  • Parkinson's disease
  • Side of onset

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