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Cited by 64Dementia and Cognitive Impairment ResearchIntensive Care Unit Cognitive DisordersFrailty in Older Adults

Apathy: prevalence, associated factors, and prognostic value among frail, older inpatients

Hölttä, Eeva H., Laakkonen, Marja-Liisa, Laurila, Jouko V., Strandberg, Timo E., Tilvis, Reijo S., Pitkälä, Kaisu H.·2012·Journal of the American Medical Directors Association
DOI 10.1016/j.jamda.2012.04.005
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Abstract

Objectives The association of apathy with Alzheimer disease and other dementias and caregiver burden has been examined in a number of studies; however, less is known about its relationship with delirium and mortality. We aimed to investigate the prevalence, relationship with delirium and dementia, and prognostic value of apathy in an elderly and frail inpatient population.Setting and participants The cohort included 425 patients in acute geriatric wards and in 7 nursing homes in Helsinki (1999-2000). Demographic factors, physical functioning, diagnoses, and drugs were assessed with special reference for dementia, delirium, and apathy. Mortality was registered from central registers.Results Of the patients, 98 (23.1%) suffered from apathy, and it was more frequent among men (32% versus 21% women, P = .037 ). There was no difference in mean age, number of comorbidities, or in the mean number of medications between those with and without apathy; however, those with apathy had lower mean MMSE points (9.2 versus 14.0 without apathy, P < .001), more often severe dementia according to Clinical Dementia Rating, and higher dependence in activities of daily living (P = .001). Furthermore, patients with apathy were more often suffering from delirium (37.8% versus 21.1%, P ≤ .001). Mortality during the 1-year follow-up was 34.7% (n = 34) and 22.0% (n = 72) among individuals with and without apathy, respectively (P = .011). In the Cox proportional hazard model with age, gender, activities of daily living, and delirium as covariates, apathy significantly predicted mortality (HR 1.89, 95% CI 1.24 to 2.89; P = .003).Conclusions Apathy is a common and serious neuropsychiatric symptom associated with cognitive decline, delirium, and disability, and it also independently predicts mortality.

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  • Anhedonia and apathy confer risks for physical disability, functional impairment, and death independent of depression.

    “anhedonia and apathy, common non-somatic symptoms of depression that are also prevalent in non-clinically depressed populations (Ishii, Weintraub, and Mervis 2009;Ritchie, Hearld, Gross, Allman, Sawyer, Sheppard, Salanitro, Locher, Brown, and Roth 2013) confer risks for physical disability, functional impairment, and death independent of depression (Covinsky, Cenzer, Yaffe, O'Brien, and Blazer 201”

    From Successful aging: Advancing the science of physical independence in older adults (2015) · cites this paper as Holtta et al. 2012

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Authors
Hölttä, E. H., Laakkonen, M.-L., Laurila, J. V., Strandberg, T. E., Tilvis, R. S., & Pitkälä, K. H.
Affiliations
  • Helsinki University Hospital (FI)
  • University of Helsinki (FI)
Corresponding author
Hölttä, Eeva H.
ORCID
Venue
Journal of the American Medical Directors Association
Publisher
Elsevier BV
Published
2012-07
Volume
13
Issue
6
Pages
541-545
ISSN
1525-8610 (ISSN-L)
DOI
10.1016/j.jamda.2012.04.005
OpenAlex
W2025967734
Cited by
64
References
35
Citations by year
2026: 2 · 2025: 4 · 2024: 5 · 2023: 1 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 7 · 2018: 5 · 2017: 7 · 2016: 2 · 2015: 5 · 2014: 6 · 2013: 6 · 2012: 2
FWCI
4.32
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Medical Directors Association (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
  • Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Keywords
apathy, frail elderly, delirium, dementia, mortality, prognostic factors, neuropsychiatric symptoms, activities of daily living, cognitive decline, nursing home residents, hospitalized older adults
MeSH terms
Activities of Daily Living, Aged, Aged, 80 and over, Delirium, Dementia, Female, Finland, Humans, Inpatients, Male, Prognosis, Risk Factors, Sex Factors, Prevalence, Proportional Hazards Models, Frail Elderly, Statistics, Nonparametric, Apathy

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