Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
Department of General Internal Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
BMC Neurol. 2020 Nov 14;20(1):416. doi: 10.1186/s12883-020-01978-9.
Apathy is one of the most common symptoms of Alzheimer's disease (AD), however, correlations of apathy with demographic variables, cognitive functions, neuropsychiatric symptoms, activity of daily living and olfactory functions in AD patients are still lacking comprehensive investigations.
This is a cross-sectional study. Total 124 typical AD patients were consecutively recruited from April 2014 to April 2017. In 124 AD patients, 47 cases (37.9%) were male and 77 cases were female; patients' age were 43-93 years with an average of 68 years. Patients were divided into AD with apathy (AD-A) and AD with no apathy (AD-NA) groups according to the score of Modified Apathy Evaluation Scale, then were evaluated cognitive functions, neuropsychiatric symptoms and activity of daily living, and tested olfactory functions. Above variables were compared between AD-A and AD-NA groups. Further correlation analyses and linear regression analysis were performed between apathy and above variables.
Compared with AD-NA group, global cognitive level, verbal memory, verbal fluency and activity of daily living were significantly compromised in AD-A group (P < 0.002); depression and agitation were severely displayed in AD-A group (P < 0.002). Apathy was negatively correlated with global cognitive function, verbal memory, verbal fluency and activity of daily living (P < 0.05). There was no significant difference of olfactory functions between the two groups (P > 0.002), and correlations between apathy and olfactory threshold, olfactory identification and global olfactory function were significant (P < 0.05) but quite weak (|r| < 0.3). Further linear regression analysis showed that only verbal fluency and instrumental activities of daily living were independently associated with apathy.
Independent correlations among apathy, verbal fluency and instrumental activities of daily living in AD patients might be related to the common brain area involved in their pathogeneses.
淡漠是阿尔茨海默病（AD）最常见的症状之一，但淡漠与 AD 患者的人口统计学变量、认知功能、神经精神症状、日常生活活动和嗅觉功能的相关性仍缺乏全面的研究。
这是一项横断面研究。2014 年 4 月至 2017 年 4 月连续招募了 124 例典型 AD 患者。在 124 例 AD 患者中，47 例（37.9%）为男性，77 例为女性；患者年龄 43-93 岁，平均 68 岁。根据改良淡漠评估量表的评分，将患者分为有淡漠的 AD 组（AD-A）和无淡漠的 AD 组（AD-NA），然后评估认知功能、神经精神症状和日常生活活动，并测试嗅觉功能。比较 AD-A 组和 AD-NA 组之间的上述变量。进一步对淡漠与上述变量进行相关性分析和线性回归分析。
与 AD-NA 组相比，AD-A 组的总体认知水平、言语记忆、言语流畅性和日常生活活动明显受损（P<0.002）；AD-A 组表现出严重的抑郁和激越（P<0.002）。淡漠与总体认知功能、言语记忆、言语流畅性和日常生活活动呈负相关（P<0.05）。两组间嗅觉功能无显著差异（P>0.002），淡漠与嗅觉阈值、嗅觉识别和总体嗅觉功能呈显著相关（P<0.05），但相关性较弱（|r|<0.3）。进一步的线性回归分析显示，只有言语流畅性和工具性日常生活活动与淡漠独立相关。
AD 患者淡漠与言语流畅性和工具性日常生活活动之间的独立相关性可能与它们发病机制中涉及的共同脑区有关。
