Department of Research and Innovation, Helse Fonna HF Haugesund Hospital, Postbox 2170, N-5504, Haugesund, Norway.
Department of Geriatric Psychiatry, Clinic of Psychiatry, Helse Fonna HF Haugesund Hospital, Postbox 2170, N-5504, Haugesund, Norway.
Alzheimers Res Ther. 2018 Aug 18;10(1):83. doi: 10.1186/s13195-018-0416-5.
Little is known about the consequences of apathy in dementia with Lewy bodies (DLB), because previous research on apathy in dementia focused mainly on Alzheimer's disease (AD).
In this longitudinal study, we included patients with AD (n = 128) and patients with DLB (n = 81). At baseline, we analyzed the associations between apathy and cognition in the total sample and in AD and DLB separately. Generalized linear mixed models were used to investigate the association between apathy and Mini Mental State Examination (MMSE) over 4 years, and the Kaplan-Meier method was used to assess the association between apathy and survival or nursing home admission.
In patients with DLB, apathy was associated with a faster global cognitive decline (MMSE) over 4 years. Patients with DLB and apathy had shorter time until nursing home admission than DLB patients without apathy and patients with AD, regardless of apathy. At baseline, patients with apathy had decreased performance on the Stroop color test and a composite executive function score. Neurocognition was unaffected by apathy in AD, but DLB patients with apathy had more verbal learning difficulties.
Apathy seems to be associated with more serious symptomatology in DLB than in AD. It is important to focus on apathy in dementia because it is one of the most prevalent and disturbing behavioral and psychological symptoms.
Lewy 体痴呆（DLB）患者淡漠的后果知之甚少，因为以前关于痴呆淡漠的研究主要集中在阿尔茨海默病（AD）上。
在这项纵向研究中，我们纳入了 AD 患者（n=128）和 DLB 患者（n=81）。在基线时，我们分析了总样本以及 AD 和 DLB 亚组中淡漠与认知之间的关联。使用广义线性混合模型来研究 4 年内淡漠与简易精神状态检查（MMSE）之间的关系，Kaplan-Meier 方法评估淡漠与生存或入住养老院之间的关系。
在 DLB 患者中，淡漠与 4 年内的总体认知下降（MMSE）相关。与无淡漠的 DLB 患者和 AD 患者相比，有淡漠的 DLB 患者在出现入住养老院的情况之前，所需时间更短。在基线时，淡漠的患者在 Stroop 颜色测试和复合执行功能评分上的表现较差。淡漠对 AD 患者的神经认知没有影响，但有淡漠的 DLB 患者在词语学习方面存在更多困难。
与 AD 相比，淡漠似乎与 DLB 更严重的症状相关。关注痴呆患者的淡漠很重要，因为这是最常见和最令人困扰的行为和心理症状之一。
