Department of Psychology, University of Cape Town, Cape Town, South Africa.
J Alzheimers Dis. 2024;98(2):579-591. doi: 10.3233/JAD-230426.
Alzheimer's disease (AD) is the most common cause of dementia. Its initially characterized by progressive short-term memory loss followed by cross-domain cognitive decline in later stages resulting in significant functional deficits and loss of activities of daily living (ADLs) independence. Apathy and depression are frequent neuropsychiatric sequelae in AD, but their contribution to functional deficits is poorly understood.
We aimed to quantitatively investigate if apathy and depressive symptoms predict ADLs in AD. We also wanted to fractionate apathy dimensions by factor-analyzing the apathy evaluation scale (AES) and then investigate the dimensions' relation to ADLs.
We recruited a sample of 115 patients with probable or possible AD and assessed them for depression, apathy, and ADLs alongside other measures. We hypothesized that apathy and depressive symptoms would predict ADLs and that AES items will load into cognitive, behavioral, and affective factors that would differentially relate to ADLs.
Our results indicated that apathy symptoms predict ADLs deficits. The AES items resolved into a three-factor solution but the manner of clustering diverged from that proposed by AES authors. When these factors were regressed simultaneously, only behavioral apathy predicted global ADLs. Distinguishing basic from instrumental ADLs showed that behavioral and cognitive apathy symptoms associate with ADLs deficits while affective symptoms do not.
Our results highlight the influence of apathy on ADLs in AD. This has important implications for patient care considering the high prevalence of apathy in AD and other dementing illnesses.
阿尔茨海默病（AD）是痴呆症最常见的病因。其最初的特征是进行性短期记忆丧失，随后在后期出现跨领域认知能力下降，导致严重的功能缺陷和日常生活活动（ADL）独立性丧失。淡漠和抑郁是 AD 常见的神经精神后遗症，但它们对功能缺陷的贡献尚不清楚。
我们旨在定量研究淡漠和抑郁症状是否预测 AD 的 ADL。我们还想通过对淡漠评估量表（AES）进行因子分析来细分淡漠维度，然后研究这些维度与 ADL 的关系。
我们招募了 115 名可能患有 AD 的患者，并对他们进行了抑郁、淡漠和 ADL 评估，以及其他一些测量。我们假设淡漠和抑郁症状会预测 ADL，并且 AES 项目会加载到认知、行为和情感因素中，这些因素会与 ADL 有差异的关系。
我们的结果表明，淡漠症状预测 ADL 缺陷。AES 项目解析为三因素解决方案，但聚类方式与 AES 作者提出的方式不同。当这些因素同时回归时，只有行为性淡漠预测了整体 ADL。区分基本和工具性 ADL 表明，行为性和认知性淡漠症状与 ADL 缺陷相关，而情感症状则不相关。
我们的结果强调了淡漠对 AD 中 ADL 的影响。考虑到 AD 和其他痴呆症中淡漠的高患病率，这对患者护理具有重要意义。
