TY - JOUR
T1 - A data-driven examination of apathy and depressive symptoms in dementia with independent replication
AU - for the Alzheimer's Disease Neuroimaging Initiative
AU - Vasconcelos Da Silva, Miguel
AU - Melendez-Torres, Gerardo Javier
AU - Ismail, Zahinoor
AU - Testad, Ingelin
AU - Ballard, Clive
AU - Creese, Byron
AU - Weiner, Michael
AU - Aisen, Paul
AU - Petersen, Ronald
AU - Jack, Clifford R.
AU - Jagust, William
AU - Trojanowki, John Q.
AU - Toga, Arthur W.
AU - Beckett, Laurel
AU - Green, Robert C.
AU - Saykin, Andrew J.
AU - Morris, John
AU - Shaw, Leslie M.
AU - Liu, Enchi
AU - Montine, Tom
AU - Thomas, Ronald G.
AU - Donohue, Michael
AU - Walter, Sarah
AU - Gessert, Devon
AU - Sather, Tamie
AU - Jiminez, Gus
AU - Harvey, Danielle
AU - Donohue, Michael
AU - Bernstein, Matthew
AU - Fox, Nick
AU - Thompson, Paul
AU - Schuff, Norbert
AU - DeCArli, Charles
AU - Borowski, Bret
AU - Gunter, Jeff
AU - Senjem, Matt
AU - Vemuri, Prashanthi
AU - Jones, David
AU - Kantarci, Kejal
AU - Ward, Chad
AU - Koeppe, Robert A.
AU - Foster, Norm
AU - Reiman, Eric M.
AU - Chen, Kewei
AU - Mathis, Chet
AU - Landau, Susan
AU - Cairns, Nigel J.
AU - Householder, Erin
AU - Reinwald, Lisa Taylor
AU - Lee, Virginia
AU - Korecka, Magdalena
AU - Figurski, Michal
AU - Crawford, Karen
AU - Neu, Scott
AU - Foroud, Tatiana M.
AU - Potkin, Steven
AU - Shen, Li
AU - Kelley, Faber
AU - Kim, Sungeun
AU - Nho, Kwangsik
AU - Kachaturian, Zaven
AU - Frank, Richard
AU - Snyder, Peter J.
AU - Molchan, Susan
AU - Kaye, Jeffrey
AU - Quinn, Joseph
AU - Lind, Betty
AU - Carter, Raina
AU - Dolen, Sara
AU - Schneider, Lon S.
AU - Pawluczyk, Sonia
AU - Beccera, Mauricio
AU - Teodoro, Liberty
AU - Spann, Bryan M.
AU - Brewer, James
AU - Van der Swag, Helen
AU - Fleisher, Adam
AU - Heidebrink, Judith L.
AU - Lord, Joanne L.
AU - Petersen, Ronald
AU - Mason, Sara S.
AU - Albers, Colleen S.
AU - Knopman, David
AU - Johnson, Kris
AU - Doody, Rachelle S.
AU - Meyer, Javier Villanueva
AU - Chowdhury, Munir
AU - Rountree, Susan
AU - Dang, Mimi
AU - Stern, Yaakov
AU - Honig, Lawrence S.
AU - Bell, Karen L.
AU - Ances, Beau
AU - Morris, John C.
AU - Carroll, Maria
AU - Leon, Sue
AU - Householder, Erin
AU - Mintun, Mark A.
AU - Schneider, Stacy
AU - Oliver, Angela
AU - Marson, Daniel
AU - Griffith, Randall
AU - Clark, David
AU - Geldmacher, David
AU - Brockington, John
AU - Roberson, Erik
AU - Grossman, Hillel
AU - Mitsis, Effie
AU - deToledoMorrell, Leyla
AU - Shah, Raj C.
AU - Duara, Ranjan
AU - Varon, Daniel
AU - Greig, Maria T.
AU - Roberts, Peggy
AU - Albert, Marilyn
AU - Onyike, Chiadi
AU - D'Agostino, Daniel
AU - Kielb, Stephanie
AU - Galvin, James E.
AU - Pogorelec, Dana M.
AU - Cerbone, Brittany
AU - Michel, Christina A.
AU - Rusinek, Henry
AU - de Leon, Mony J.
AU - Glodzik, Lidia
AU - De Santi, Susan
AU - Murali Doraiswamy, P.
AU - Petrella, Jeffrey R.
AU - Wong, Terence Z.
AU - Arnold, Steven E.
AU - Karlawish, Jason H.
AU - Wolk, David
AU - Smith, Charles D.
AU - Jicha, Greg
AU - Hardy, Peter
AU - Sinha, Partha
AU - Oates, Elizabeth
AU - Conrad, Gary
AU - Lopez, Oscar L.
AU - Oakley, Mary Ann
AU - Simpson, Donna M.
AU - Porsteinsson, Anton P.
AU - Goldstein, Bonnie S.
AU - Martin, Kim
AU - Makino, Kelly M.
AU - Ismail, M. Saleem
AU - Brand, Connie
AU - Mulnard, Ruth A.
AU - Thai, Gaby
AU - Mc Adams Ortiz, Catherine
AU - Womack, Kyle
AU - Womack, Kyle
AU - Quiceno, Mary
AU - Arrastia, Ramon Diaz
AU - King, Richard
AU - Weiner, Myron
AU - Martin Cook, Kristen
AU - DeVous, Michael
AU - Levey, Allan I.
AU - Lah, James J.
AU - Cellar, Janet S.
AU - Burns, Jeffrey M.
AU - Anderson, Heather S.
AU - Swerdlow, Russell H.
AU - Apostolova, Liana
AU - Tingus, Kathleen
AU - Woo, Ellen
AU - Silverman, Daniel H.S.
AU - Lu, Po H.
AU - Bartzokis, George
AU - Graff Radford, Neill R.
AU - Parfitt, Francine
AU - Kendall, Tracy
AU - Johnson, Heather
AU - Farlow, Martin R.
AU - Hake, Ann Marie
AU - Matthews, Brandy R.
AU - Herring, Scott
AU - Hunt, Cynthia
AU - van Dyck, Christopher H.
AU - Carson, Richard E.
AU - MacAvoy, Martha G.
AU - Chertkow, Howard
AU - Bergman, Howard
AU - Hosein, Chris
AU - Black, Sandra
AU - Stefanovic, Bojana
AU - Caldwell, Curtis
AU - Hsiung, Ging Yuek Robin
AU - Feldman, Howard
AU - Mudge, Benita
AU - Assaly, Michele
AU - Kertesz, Andrew
AU - Rogers, John
AU - Trost, Dick
AU - Bernick, Charles
AU - Munic, Donna
AU - Kerwin, Diana
AU - Mesulam, Marek Marsel
AU - Lipowski, Kristine
N1 - Publisher Copyright:
© 2023 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Apathy is one of the most common neuropsychiatric symptoms (NPS) and is associated with poor clinical outcomes. Research that helps define the apathy phenotype is urgently needed, particularly for clinical and biomarker studies. We used latent class analysis (LCA) with two independent cohorts to understand how apathy and depression symptoms co-occur statistically. We further explored the relationship between latent class membership, demographics, and the presence of other NPS. The LCA identified a four-class solution (no symptoms, apathy, depression, and combined apathy/depression), reproducible over both cohorts, providing robust support for an apathy syndrome distinct from depression and confirming that an apathy/depression syndrome exists, supported by the model fit test with the four-class solution scores evidencing better fitting (Bayesian information criterion adjusted and entropy R2). Using a data-driven method, we show distinct and statistically meaningful co-occurrence of apathy and depressive symptoms. There was evidence that these classes have different clinical associations, which may help inform diagnostic categories for research studies and clinical practice. Highlights: We found four classes: no symptoms, apathy, depression and apathy/depression. Apathy conferred a higher probability for agitation. Apathy diagnostic criteria should include accompanying neuropsychiatric symptoms.
AB - Apathy is one of the most common neuropsychiatric symptoms (NPS) and is associated with poor clinical outcomes. Research that helps define the apathy phenotype is urgently needed, particularly for clinical and biomarker studies. We used latent class analysis (LCA) with two independent cohorts to understand how apathy and depression symptoms co-occur statistically. We further explored the relationship between latent class membership, demographics, and the presence of other NPS. The LCA identified a four-class solution (no symptoms, apathy, depression, and combined apathy/depression), reproducible over both cohorts, providing robust support for an apathy syndrome distinct from depression and confirming that an apathy/depression syndrome exists, supported by the model fit test with the four-class solution scores evidencing better fitting (Bayesian information criterion adjusted and entropy R2). Using a data-driven method, we show distinct and statistically meaningful co-occurrence of apathy and depressive symptoms. There was evidence that these classes have different clinical associations, which may help inform diagnostic categories for research studies and clinical practice. Highlights: We found four classes: no symptoms, apathy, depression and apathy/depression. Apathy conferred a higher probability for agitation. Apathy diagnostic criteria should include accompanying neuropsychiatric symptoms.
KW - apathy
KW - dementia
KW - depression
KW - latent class analysis
UR - http://www.scopus.com/inward/record.url?scp=85151426851&partnerID=8YFLogxK
U2 - 10.1002/dad2.12398
DO - 10.1002/dad2.12398
M3 - Article
C2 - 36777092
AN - SCOPUS:85151426851
SN - 2352-8729
VL - 15
JO - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
JF - Alzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
IS - 1
M1 - e12398
ER -