Apathy in late-life depression: common, persistent, and disabling.

Abstract

OBJECTIVE:

The aims of this study were to examine: (1) the relationship between apathy and disability in late-life depression, and (2) the functional significance of improvement in apathy following escitalopram treatment in terms of its relationship to disability.

METHODS:

Subjects were 71 non-demented elderly with non-psychotic major depression. After a 2-week single-blind placebo period, subjects who had Hamilton Depression Rating Scale (HDRS) ≥ 18 received escitalopram 10 mg daily for 12 weeks. Apathy and disability were assessed with the Apathy Evaluation Scale (AES) and the World Health Organization Disability Assessment Scale II (WHODAS), respectively. These measures and the HDRS were administered at baseline and again following 12 weeks of treatment.

RESULTS:

At baseline, 38% of depressed subjects had significant apathy (AES ≥ 36.5). Severity of apathy at baseline significantly correlated with severity of disability. In a multivariate regression model, baseline severity of apathy, but not the overall depressive syndrome (HDRS), significantly correlated with baseline disability. Following escitalopram treatment, improvement in apathy significantly correlated with improvement in disability measures, while change in the rest of the depressive syndrome did not. The overall change in apathy and disability in response to escitalopram treatment was significant but small.

CONCLUSION:

Apathy is common in late-life depression and is associated with disability above and beyond the influence of other depressive symptoms. Given the strong relationship between apathy and disability, understanding the neurobiology of apathy and developing treatments for apathy may improve the functional outcomes of late-life depression.

• Authors: Genevieve S Yuen, Saumya Bhutani, Bryony J Lucas, Faith M Gunning, Bassem AbdelMalak, Joanna K Seirup, Sibel A Klimstra, George S Alexopoulos
• Journal: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry (Am J Geriatr Psychiatry) Vol. 23 Issue 5 Pg. 488-94 (May 2015) ISSN: 1545-7214 [Electronic] England
• PMID: 25047306 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Chemical References

• Antidepressive Agents, Second-Generation
• Citalopram

Topics

• Aged
• Antidepressive Agents, Second-Generation (administration & dosage)
• Apathy
• Citalopram (administration & dosage)
• Depressive Disorder (diagnosis)
• Depressive Disorder, Major (diagnosis, drug therapy, psychology)
• Diagnostic and Statistical Manual of Mental Disorders
• Disability Evaluation
• Female
• Geriatric Assessment
• Humans
• Late Onset Disorders
• Male
• Psychiatric Status Rating Scales
• Statistics as Topic
• Treatment Outcome