Prevalence, symptoms and risk profiles of apathy at old age

Koolhoven, I. (2017)

Doctoral Thesis

This thesis investigates different aspects of apathy - as a distinct clinical syndrome assessed with the Apathy Scale- in older persons with and without concurrent depression. In Chapter 2, clinically relevant subtypes of apathy according to the Apathy Scale in older persons from the PROMODE study are examined, using data-driven Latent Class Analysis (LCA). Further, specific characteristics across the classes identified by LCA are investigated. Then, in Chapter 3, cross-sectionally the prevalence, severity and clinical profile of apathy in depressed and non-depressed older persons, in relation to various possible determinants is described. Chapter 4 examines which characteristics predict, over a 2-year period, the incidence and course of apathy in at baseline depressed older persons from the NESDO study. Chapter 5, using data of the NESDO and NESDA, investigates the presence of  apathy in late-life compared to early-life depression, and various determinants of clinically relevant apathy in older compared to younger depressed persons. In Chapter 6 the association of the presence of apathy among community-dwelling older persons from the PROMODE study and a diminished quality of life is examined. All results are placed a current perspective in Chapter 7 that also discusses clinical implications, and makes some recommendations for future research.

• Apathy
• Amotivation
• Old age
• Latent Class analysis
• Subtypes of apathy
• Apathy Scale
• Depression
• Quality of life
• Cognition
• Early- and late-life

• All authors: Koolhoven, I.
• Supervisor: Mast, R.C. van der
• Co-supervisor: Comijs, H.C.; Naarding, P.
• Committee: Achterberg, W.P.; Gussekloo, J.; Stek, M.L.; Verhey, F.R.J.
• Qualification: Doctor (dr.)
• Awarding Institution: Psychiatrie, Medicine / Leiden University Medical Center (LUMC), Leiden University
• Date: 2017-11-07
• ISBN (print): 9789077877210
• Sponsorship: The infrastructure for the NESDO study (http://nesdo.amstad.nl) is funded through the Fonds NutsOhra (project 0701-065), Stichting tot Steun VCVGZ, NARSAD The Brain and Behavior Research Fund (Grand Id 41080) and the participating universities and mental health care organizations (VU University Medical Center, Leiden University Medical Center, University Medical Center Groningen, UMC St Radboud, and GGZinGeest, GGNet, GGZNijmegen, GGZRivierduinen, Lentis, and Parnassia). The infrastructure for the NESDA study (www.nesda.nl) has been funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development (Zon-Mw, grant number 10- 000−1002) and participating universities (VU University Medical Center, Leiden University Medical Center, University Medical Center Groningen). The infrastructure for the PROMODE study was funded by a grant from the Netherlands Organisation for Health Research and Development (ZonMw; grant 945-07-502) and a grant from Rivierduinen, Mental Health Institution. Financial support for the publication of this thesis by the Parnassia Academy (part of Parnassia Psychiatric Institute) is gratefully acknowledged.