Apathy is an independent risk factor for incident cardiovascular disease in the older individual: a population-based cohort study

作者：Eurelings Lisa S M^*; Ligthart Suzanne A; van Dalen Jan Willem; van Charante Eric P Moll; van Gool Willem A; Richard Edo

来源：International Journal of Geriatric Psychiatry, 2014, 29(5): 454-463.

DOI：10.1002/gps.4026

• apathy
• depression
• cardiovascular disease
• stroke

ObjectiveAlthough depression is considered to be associated with cardiovascular disease (CVD), specifically symptoms of apathy have been strongly associated with a history of CVD in recent studies. In this study, we prospectively assess whether symptoms of apathy and depression are independent risk factors for incident CVD and stroke.
MethodsWe carried out a prospective cohort study of 1810 community-dwelling older individuals (70-78years) without a history of CVD or stroke. Symptoms of apathy and depression were assessed with the 15-item Geriatric Depression Scale. Incident CVD and stroke were assessed after 2years follow-up. The associations of symptoms of apathy and depression with incident CVD and stroke were analyzed separately using logistic regression analysis.
ResultsSymptoms of apathy and depression were present in 281 (15.5%) and 266 (14.7%) participants, respectively. Incident CVD occurred in 62 (3.5%) participants and stroke in 55 (3.1%) participants. Apathy was associated with incident CVD after adjustment for demographics and cardiovascular risk factors (odds ratio (OR)=2.60, 95% CI=1.46-4.65). Exclusion of subjects with depressive symptoms yielded a similar OR (2.94, 95% CI=1.45-5.96, n=1544). No association was found between depressive symptoms and incident CVD. Neither apathy symptoms nor depressive symptoms were associated with incident stroke.
ConclusionsApathy, but not depression, is a strong, independent risk factor for incident CVD. It may be a marker of underlying vascular disease. By its nature, apathy may cause non-adherence to a healthy lifestyle, diminished activities, and possibly even withdrawal from clinical care aimed at improving vascular risk profiles.

• 出版日期2014-5