Abstract Details

Title Apathy in Dementia with Lewy Bodies: Frequency and Impact on Patient and Caregiver Experiences

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 12-004

Objective

To determine frequency and correlates of apathy in dementia with Lewy bodies (DLB).

Background

Apathy is a common behavioral symptom in parkinsonian syndromes. Limited prior research investigates the frequency and impact of apathy in DLB.

Design/Methods

A retrospective review of two databases was conducted: (1) a University of Florida clinical database and (2) the Predicting Accurately End-of-Life in DLB and Promoting Quality End-of-Life Experiences (PACE-DLB) study in moderate-advanced DLB. Apathy was assessed via the Starkstein Apathy Scale in the former and the Neuropsychiatric Inventory–Questionnaire (NPI-Q) in the latter. Apathy was correlated with other available measures in each database including the Beck Depression Inventory (BDI-II), Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), NPI-Q, motor Unified Parkinson's Disease Rating Scale (UDPRS), cognitive screens (MMSE, MOCA), Quick Dementia Rating System (QDRS), and quality of life (Quality of Life-Alzheimer's Disease Scale, QoL-AD). For correlations, strength was assessed as weak if <0.4, moderate if 0.4 to 0.59, and strong if >0.59.

Results

For individuals with DLB in the clinical database (76% men, mean age 73, mean disease duration 2.18y), 80% had apathy. Apathy correlated with depression (BDI-II: r=0.562, p<0.001; GDS: r=0.773, p=0.042), anxiety (BAI: r=0.478, p=0.002), and motor symptoms (r=0.248; p=0.013) but not cognitive screening (performed in a subset). In PACE-DLB (78% men, mean age 75, mean disease duration 3.24y), 78% had apathy. Apathy correlated with cognitive severity (QDRS; r=0.162, p=0.026), depression (NPI-Q: r=0.263, p<0.001), anxiety (NPI-Q: r=0.155, p=0.034) and participant quality of life (QoL-AD: r=-0.319, p=0.006) but not hallucinations or delusions. Apathy correlated with caregiver quality of life (QoL-AD: r=-0.149, p=0.005) but not depression or burden.

Conclusions

Apathy is highly prevalent in DLB and correlates with cognitive severity, anxiety, depression and quality of life. This study underscores the importance of screening for apathy. Additional research is needed to identify pharmacologic and non-pharmacologic treatments.

Authors/Disclosures
Anastasia Barnes, MD PRESENTER	Dr. Barnes has nothing to disclose.
Tingchang Wang, PhD	Mr. Wang has nothing to disclose.
Alfonso Enrique Martinez Nunez, MD	Dr. Martinez Nunez has nothing to disclose.
Zhigang Li, PhD	Dr. Li has nothing to disclose.
Melissa Armstrong, MD, MSc, FAAN, FAAN (UF Department of Neurology)	The institution of Dr. Armstrong has received research support from National Institutes of Health. The institution of Dr. Armstrong has received research support from Florida Department of Health. The institution of Dr. Armstrong has received research support from Lewy Body Dementia Association. The institution of Dr. Armstrong has received research support from The Michael J. Fox Foundation. Dr. Armstrong has received personal compensation in the range of $5,000-$9,999 for serving as a DSMB member with Alzheimer's Clinical Trials Consortium. Dr. Armstrong has received personal compensation in the range of $5,000-$9,999 for serving as a DSMB member with Alzheimer's Disease Cooperative Study. Dr. Armstrong has received personal compensation in the range of $500-$4,999 for serving as a DSMB member with National Institutes of Health. Dr. Armstrong has a non-compensated relationship as a Member, Scientific Advisory Council with Lewy Body Dementia Association that is relevant to AAN interests or activities.

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