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Apathy in late-life depression among Taiwanese patients

Published online by Cambridge University Press:  26 July 2007

Shwu-Hua Lee ,
Ming-Ching Wen ,
Chia-Chen Chao ,
Ying Jen Chen  and
Cheng-Fang Yen
Shwu-Hua Lee
Affiliation:
Department of Psychiatry, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
Ming-Ching Wen
Affiliation:
Department of Psychiatry, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
Chia-Chen Chao
Affiliation:
Graduate Institute of Clinical Behavioral Science, Chang Gung University, Taiwan
Ying Jen Chen
Affiliation:
Department of Internal Medicine, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
Cheng-Fang Yen*
Affiliation:
Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Taiwan Department of Psychiatry, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
*
Correspondence should be addressed to: Cheng-Fang Yen, Department of Psychiatry, Kaohsiung Medical University Chung-Ho Memorial Hospital, No. 100, Tzyou 1st Rd, Kaohsiung 80756, Taiwan. Phone: 886 7 3121101 ext. 6822; Fax: 886 7 3134761. Email: [email protected].
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Abstract

Background: Apathy is defined as lack of motivation and occurs in a variety of neuropsychological disorders. The Apathy Evaluation Scale (AES) has been shown to be valid and reliable for assessing apathy in depression but the validity and reliability of the Chinese version has never been examined. The aims of the study were to (1) evaluate the validity and reliability of the Chinese version of the AES in late-life depression and (2) evaluate the severity of apathy in late-life depression.

Methods: We translated the AES into Chinese and used a cross-sectional design to evaluate apathy in elderly subjects. Diagnostic and Statistical Manual of Mental Disorders (DSM) -IV criteria and Hamilton Depression Rating Scale (HDRS) were applied for diagnosis and assessment. Three groups of subjects were recruited including one group (n = 31) of patients with major depressive disorder with current depression, the second group (n = 30) with major depressed disorder with remission, and the third group (n = 31) of healthy controls. Convergent validity was tested using four apathy-related items from the HDRS (loss of interest, psychomotor retardation, loss of energy, and loss of insight). Multiple forms of reliability (including internal consistency, test-retest, and interrater) and discriminant validity were examined.

Results: We demonstrated that the internal consistency (coefficient α = 0.90) and test-retest reliability (p < 0.001) were satisfied. Discriminant validity of apathy severity among these three groups was significant. The convergent validity and correlation coefficients based on the four apathy-related items from the HDRS and AES were acceptable.

Conclusion: Apathy is a distinct syndrome which may be treatable when depression is effective managed. Further application of the Chinese version of the AES to study the association of apathy with other neuropsychological symptoms is necessary.

Keywords

motivationvalidityreliabilityChinese versionapathy-related items
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 2 , April 2008 , pp. 328 - 337
Copyright
Copyright © International Psychogeriatric Association 2007

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References

Alexopoulos, G. S. et al. 2000. Executive dysfunction and long-term outcomes of geriatric depression. Archives of General Psychiatry, 57, 285–290.CrossRefGoogle ScholarPubMed
Årsland, D. et al. 1999. Range of neuropsychiatric disturbances in patients with Parkinson's disease. Journal of Neurology, Neurosurgery and Psychiatry, 67, 492–496.Google Scholar
Bartolini, M., Coccia, M., Luzzi, S., Provinciali, L. and Ceravolo, M. G. 2005. Motivational symptoms of depression mask preclinical Alzheimer's disease in elderly subjects. Dementia and Geriatric Cognitive Disorders, 19, 31–36.Google Scholar
Bhalla, R. K. et al. 2006. Persistence of neuropsychologic deficit in the remitted state of late-life depression. American Institute of Geriatric Psychiatry, 14, 419–427.Google Scholar
Benoit, M. et al. 1999. Behavioral and psychological symptoms in Alzheimer's disease. Relation between apathy and regional cerebral perfusion. Dementia and Geriatric Cognitive Disorders, 10, 511–517.Google Scholar
Berger, A. K., Fratiglioni, L., Forsell, Y., Winblad, B. and Backman, L. 1999. The occurrence of depressive symptoms in the preclinical phase of AD: a population-based study. Neurology, 53, 1998–2002.CrossRefGoogle ScholarPubMed
Bozzola, F. G., Gorelick, P. B. and Freels, S. 1992. Personality changes in Alzheimer's disease. Archives of Neurology, 49, 297–300.Google Scholar
Brislin, R. W. 1970. Back-translation for cross-culture research. Journal of Cross-Cultural Psychology, 1, 185–216.CrossRefGoogle Scholar
Craig, A. H. et al. 1996. Cerebral blood flow correlates of apathy in Alzheimer disease. Archives of Neurology, 53, 1116–1120.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. 1994. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.Google Scholar
Gabryelewicz, T. et al. 2004. Prevalence of major and minor depression in elderly persons with mild cognitive impairment-MADRS factor analysis. International Journal of Geriatric Psychiatry, 19, 1168–1172.CrossRefGoogle ScholarPubMed
Greene, J. G., Smith, R., Gardiner, M. and Timbury, G. C. 1982. Measuring behavioural disturbance of elderly demented patients in the community and its effects on relatives: a factor analytic study. Age and Ageing, 11, 121–126.CrossRefGoogle ScholarPubMed
Hamilton, M. 1960. A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.CrossRefGoogle ScholarPubMed
Kaufer, D. I. et al. 1998. Assessing the impact of neuropsychiatric symptoms in Alzheimer's disease: the Neuropsychiatric Inventory Caregiver Distress Scale. Journal of the American Geriatrics Society, 46, 210–215.Google Scholar
Krishnan, K. R. et al. 2004. Clinical characteristics of magnetic resonance imaging-defined subcortical ischemic depression. Biological Psychiatry, 55, 390–397.Google Scholar
Krishnan, K. R., Hays, J. C., Tupler, L. A., George, L. K. and Blazer, D. G. 1995. Clinical and phenomenological comparisons of late-onset and early-onset depression. American Journal of Psychiatry, 152, 785–788.Google Scholar
Landes, A. M., Sperry, S. D., Strauss, M. E. and Geldmacher, D. S. 2001. Apathy in Alzheimer's disease. Journal of the American Geriatrics Society, 49, 1700–1707.Google Scholar
Lavretsky, H., Lesser, I. M., Wohl, M., Miller, B. L. and Mehringer, C. M. 1999. Clinical and neuroradiologic features associated with chronicity in late-life depression. American Journal of Geriatric Psychiatry, 7, 309–316.CrossRefGoogle ScholarPubMed
Marin, R. S., Biedrzycki, R. C. and Firinciogullari, S. 1991. Reliability and validity of the Apathy Evaluation Scale. Psychiatry Research, 38, 143–162.CrossRefGoogle ScholarPubMed
Marin, R. S., Firinciogullari, S. and Biedrzycki, R. C. 1993. The sources of convergence between measures of apathy and depression. Journal of Affective Disorders, 28, 117–124.Google Scholar
Marin, R. S., Firinciogullari, S. and Biedrzycki, R. C. 1994. Group differences in the relationship between apathy and depression. Journal of Nervous and Mental Disease, 182, 235–239.Google Scholar
Mega, M. S., Cummings, J. L., Fiorello, T. and Gornbein, J. 1996. The spectrum of behavioral changes in Alzheimer's disease. Neurology, 46, 130–135.Google Scholar
Morris, J. C. 1993. The clinical dementia rating (CDR): current version and scoring rules. Neurology, 43, 2412–2414.CrossRefGoogle ScholarPubMed
Okada, K., Kobayashi, S., Yamagata, S., Takahashi, K. and Yamaguchi, S. 1997. Poststroke apathy and regional cerebral blood flow. Stroke, 28, 2437–2441.Google Scholar
Padala, P. R., Petty, F. and Bhatia, S. C. 2005. Methylphenidate may treat apathy independent of depression. Annals of Pharmacotherapy, 39, 1947–1949.Google Scholar
Resnick, B., Zimmerman, S. I. and Adelman, A. 1998. Use of the apathy evaluation scale as a measure of motivation in elderly people. Rehabilitation Nursing, 23, 141–147.Google Scholar
Robert, P. H. et al. 2006. Apathy in patients with mild cognitive impairment and the risk of developing dementia of Alzheimer's disease: a one-year follow-up study. Clinical Neurology and Neurosurgery, 108, 733–736.CrossRefGoogle ScholarPubMed
Starkstein, S. E., Fedoroff, J. P., Price, T. R., Leiguarda, R. and Robinson, R. G. 1993. Apathy following cerebrovascular lesions. Stroke, 24, 1625–1630.Google Scholar
Starkstein, S. E., Sabe, L., Chemerinski, E., Jason, L. and Leiguarda, R. 1996. Two domains of anosognosia in Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 61, 485–490.Google Scholar
Steffens, D. C., Hays, J. C. and Krishnan, K. R. 1999. Disability in Geriatric Depression. American Journal of Geriatric Psychiatry, 7, 34–40.Google Scholar
Tekin, S. and Cummings, J. L. 2002. Frontal-subcortical neuronal circuits and clinical neuropsychiatry: an update. Journal of Psychosomatic Research, 53, 647–654.Google Scholar