Depression, Apathy Associated With Increased Risk for Mild Cognitive Impairment
Baseline apathy was related to risk for conversion to mild cognitive impairment.
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CHICAGO — Adults with depressive symptoms and apathy in middle and late life are at a higher risk for conversion to mild cognitive impairment (MCI) and dementia, according to findings from regression analyses of patients in the National Alzheimer's Coordinating Center Uniform dataset presented at the 2018 Alzheimer's Association International Conference, July 22-26, 2018 in Chicago, Illinois.
In the past, an association between depressive symptoms and incidence of MCI and dementia has been established. Another neuropsychiatric symptom, apathy, occurs commonly in MCI and dementia "but is not well characterized as a marker of decline," noted lead author Mary F. Wyman, PhD, from the University of Wisconsin School of Medicine and Public Health, Madison, WI. Moreover, the role of antidepressants on the risk of MCI is becoming a growing topic, she added.
Dr Wyman and colleagues conducted a study to evaluate the relationship between apathy, depression, and pharmacological treatment of depression in 11,780 patients (aged ≥45 years) with normal cognition at baseline from the National Alzheimer's Coordinating Center Uniform dataset. Depressive symptoms were assessed via the Geriatric Depression Scale (GDS-15) and apathy was assessed via the Neuropsychiatric Inventory Questionnaire (NPI-Q). Analyses were performed to examine depression and apathy as predictors of conversion to MCI or dementia during follow-up (average 3.75 years). A sub-analysis was conducted (N=2124) in patients with recent depression (within 2 years) taking antidepressants at baseline as a predictor of later conversion to cognitive disorder.
The unadjusted analyses indicated White race was associated with higher risk of conversion but a lower risk of depression overall. Depression (odds ratio [OR] 1.07; 95% CI, 1.04-1.10; P <.001) and apathy (OR 1.97; 95% CI, 1.54-2.5; P <.001) were found to be significant predictors of conversion to MCI.
Among patients with recent depression, over half (61.8%) were receiving antidepressant therapy. This was associated with a decreased risk of conversion in unadjusted analyses (OR 1.63; 95% CI, 1.09-2.44; P <.05) but was not significant after adjusting for demographics and depressive severity.
Dr Wyman concluded, "Apathy at baseline was related to increased risk of conversion accounting for depression severity and treatment, confirming the potential clinical importance of this neuropsychiatric symptom for assessing risk."
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Wyman MF, Norton DL, Ma Y, et al. The association of depressive symptoms, apathy, and antidepressant use with incident MCI and dementia in the Nacc dataset. Presented at: 2018 Alzheimer's Association International Conference. July 22-26, 2018; Chicago, IL. Poster P1-365.