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A longitudinal study examining the independence of apathy and depression after stroke: the Sydney Stroke Study

Published online by Cambridge University Press:  18 August 2010

Adrienne Withall ,
Henry Brodaty ,
Annette Altendorf  and
Perminder S. Sachdev
Adrienne Withall*
Affiliation:
School of Psychiatry, University of New South Wales, Randwick, Australia Academic Department for Old Age Psychiatry, The Prince of Wales Hospital, Randwick, Australia Primary Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
Henry Brodaty
Affiliation:
School of Psychiatry, University of New South Wales, Randwick, Australia Academic Department for Old Age Psychiatry, The Prince of Wales Hospital, Randwick, Australia Primary Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
Annette Altendorf
Affiliation:
School of Psychiatry, University of New South Wales, Randwick, Australia Academic Department for Old Age Psychiatry, The Prince of Wales Hospital, Randwick, Australia
Perminder S. Sachdev
Affiliation:
School of Psychiatry, University of New South Wales, Randwick, Australia Primary Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia Neuropsychiatric Institute, The Prince of Wales Hospital, Randwick, Australia
*
Correspondence should be addressed to: Adrienne Withall, Primary Dementia Collaborative Research Centre, 45 Beach St, Coogee, NSW Australia 2034. Phone: +61 2 9385 9060; Fax: +61 2 9385 9075. Email: [email protected].
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Abstract

Background: There is growing recognition that apathy is not only a symptom of depression but may be an independent syndrome. This is the first study to investigate the relationship of apathy and depression longitudinally following stroke and to examine the association with dementia.

Method: 106 consecutive eligible participants following stroke received extensive medical, psychiatric and neuropsychological assessments at three to six months (index assessment) and 15 months (follow-up assessment) after their stroke. A subset of participants received magnetic resonance imaging (MRI) scans at index assessment. Ratings were made for DSM-IV major or minor depression and for apathy using the Apathy Evaluation Scale (AES).

Results: While there was no significant overlap between apathy and depression at index assessment (OR = 1.79, 95% CI 0.48, 6.66), the overlap was significant a year later (OR = 7.75, 95% CI 2.60, 23.13). Dementia at index assessment was a common risk factor for both apathy and depression at follow-up (OR = 12.45, 95% CI 2.98, 52.02 and OR = 10.35, 95% CI 2.84, 37.72, respectively).

Conclusions: Apathy and depression after stroke have a common predictor and overlap longitudinally. The overlap might be due to cumulative vascular pathology and because of the relationship of each of these syndromes to dementia, which was an important, possibly causal, predictor for both.

Keywords

neuropsychiatriccognitivefunctionalischemiccerebrovasculardementia
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 2 , March 2011 , pp. 264 - 273
Copyright
Copyright © International Psychogeriatric Association 2010

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