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Apathy is associated with poor prognosis in amyotrophic lateral sclerosis.
Caga, J; Turner, M R; Hsieh, S; Ahmed, R M; Devenney, E; Ramsey, E; Zoing, M C; Mioshi, E; Kiernan, M C.
Afiliación
  • Caga J; Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.
  • Turner MR; Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.
  • Hsieh S; Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK.
  • Ahmed RM; Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.
  • Devenney E; Neuroscience Research Australia, Randwick, NSW, Australia.
  • Ramsey E; Neuroscience Research Australia, Randwick, NSW, Australia.
  • Zoing MC; Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.
  • Mioshi E; Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.
  • Kiernan MC; Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
Eur J Neurol ; 23(5): 891-7, 2016 May.
Article en En | MEDLINE | ID: mdl-26822417
BACKGROUND AND PURPOSE: Apathy is the most commonly reported behavioural change in amyotrophic lateral sclerosis (ALS). However, the degree to which it affects prognosis and overlaps with depression in this population is unknown. The present study examined the relationship between level of apathy, mortality and survival time and whether apathy was linked to specific symptom clusters of depression. METHODS: A cohort of 76 consecutive ALS patients attending specialized multidisciplinary clinics were classified according to level of apathy. The effects of clinical factors and apathy on survival time were analysed using univariate and multivariate methods. RESULTS: The majority of patients with moderate to severe apathy died during the study (P = 0.003) and had a median survival time of 21.7 months, considerably shorter than patients with mild apathy (46.9 months) and no apathy (51.9 months) (P = 0.0001). Apathy remained a significant predictor of survival even after controlling for clinical factors and symptom duration at the time of study entry (hazard ratio 3.8, 95% confidence interval 1.9-7.5, P = 0.0001). Depression with demoralization was not associated with level of apathy (P = 0.172) whereas depression with anhedonia was more common in patients with apathy than in those without apathy (P = 0.006). CONCLUSIONS: The presence of severe apathy is an independent, negative prognostic factor in ALS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Depresión / Apatía / Esclerosis Amiotrófica Lateral Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Depresión / Apatía / Esclerosis Amiotrófica Lateral Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido