Department of Mental Health, Johns Hopkins University School of Public Health, Baltimore, Maryland, USA.
Int Psychogeriatr. 2010 Aug;22(5):819-29. doi: 10.1017/S1041610209991402. Epub 2010 May 18.
Apathy, a complex neuropsychiatric syndrome, commonly affects patients with Alzheimer's disease. Prevalence estimates for apathy range widely and are based on cross-sectional data and/or clinic samples. This study examines the relationships between apathy and cognitive and functional declines in non-depressed community-based older adults.
Data on 1,136 community-dwelling adults aged 50 years and older from the Baltimore Epidemiologic Catchment Area (ECA) study, with 1 and 13 years of follow-up, were used. Apathy was assessed with a subscale of items from the General Health Questionnaire. Logistic regression, t-tests, chi2 and Generalized Estimating Equations were used to accomplish the study's objectives.
The prevalence of apathy at Wave 1 was 23.7%. Compared to those without, individuals with apathy were on average older, more likely to be female, and have lower Mini-mental State Examination (MMSE) scores and impairments in basic and instrumental functioning at baseline. Apathy was significantly associated with cognitive decline (OR = 1.65, 95% CI = 1.06, 2.60) and declines in instrumental (OR = 4.42; 95% CI = 2.65, 7.38) and basic (OR = 2.74; 95%CI = 1.35, 5.57) function at 1-year follow-up, even after adjustment for baseline age, level of education, race, and depression at follow-up. At 13 years of follow-up, apathetic individuals were not at greater risk for cognitive decline but were twice as likely to have functional decline. Incidence of apathy at 1-year follow up and 13-year follow-up was 22.6% and 29.4%, respectively.
These results underline the public health importance of apathy and the need for further population-based studies in this area.
冷漠是一种常见于阿尔茨海默病患者的复杂神经精神综合征。冷漠的患病率估计差异很大，这是基于横断面数据和/或临床样本得出的。本研究探讨了无抑郁的社区老年人中冷漠与认知和功能下降之间的关系。
本研究使用了来自巴尔的摩流行病学捕获区（ECA）研究的 1136 名年龄在 50 岁及以上的社区居住成年人的数据，随访时间为 1 年和 13 年。冷漠通过一般健康问卷的项目子量表进行评估。使用逻辑回归、t 检验、卡方检验和广义估计方程来实现研究目标。
第 1 波冷漠的患病率为 23.7%。与无冷漠者相比，冷漠者的平均年龄较大，更有可能为女性，并且在基线时的简易精神状态检查（MMSE）评分和基本及工具性功能受损。冷漠与认知能力下降显著相关（OR=1.65，95%CI=1.06，2.60），与工具性（OR=4.42；95%CI=2.65，7.38）和基本（OR=2.74；95%CI=1.35，5.57）功能下降相关，在调整了基线年龄、教育水平、种族和随访时的抑郁后，这一结果仍有意义。在 13 年的随访中，冷漠者认知能力下降的风险没有增加，但功能下降的风险增加了一倍。第 1 年和第 13 年随访时冷漠的发生率分别为 22.6%和 29.4%。
这些结果强调了冷漠的公共卫生重要性，需要在这一领域进行进一步的基于人群的研究。
