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Association between apathy/depression and executive function in patients with Alzheimer's disease

Published online by Cambridge University Press:  08 May 2008

Shutaro Nakaaki ,
Yoshie Murata ,
Junko Sato ,
Yoshihiro Shinagawa ,
Jin Hongo ,
Hiroshi Tatsumi ,
Nobutsugu Hirono ,
Masaru Mimura  and
Toshiaki A. Furukawa
Shutaro Nakaaki*
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Yoshie Murata
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Junko Sato
Affiliation:
Yagoto Hospital, Nagoya, Japan
Yoshihiro Shinagawa
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Jin Hongo
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Hiroshi Tatsumi
Affiliation:
Nagoya Daini Red Cross Hospital, Nagoya, Japan
Nobutsugu Hirono
Affiliation:
Department of Psychology, Kobegakuin University, Kobe, Japan
Masaru Mimura
Affiliation:
Department of Neuropsychiatry, Showa University School of Medicine, Tokyo, Japan
Toshiaki A. Furukawa
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
*
Correspondence should be addressed to: Clinical Professor Shutaro Nakaaki, Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. Phone: +81 52 853 8271; Fax: +81 52 852 0837. Email: hzi05510@nifty.com.
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Abstract

Background: Apathy and depression may be strongly associated with executive dysfunction in Alzheimer's disease (AD). The Frontal Assessment Battery (FAB) is an instrument for assessing executive function. The dual task paradigm is also useful for assessing divided attention. However, the association between apathy/depression and these tasks is unclear.

Methods: Both the FAB and the dual task were used to evaluate AD patients. A two-way analysis of variance was then conducted between the FAB and dual task results and the absence versus the presence of depression or the absence versus the presence of apathy.

Results: Of 88 patients with AD, 26 had both apathy and depression, 26 had depression only, 18 had apathy only, and 18 had neither. Total FAB scores and dual task scores differed significantly between the AD patients with depression and those without depression; the scores were also different between those with apathy and those without apathy. Also, a significant interaction between depression and apathy was noted for the total FAB and dual task scores.

Conclusions: The deficits in the total FAB and dual task scores were larger in AD patients with both apathy and depression compared with patients with either apathy or depression alone. AD patients with both symptoms may have greater deficits in frontal lobe function relative to AD patients with either apathy or depression alone.

Keywords

Frontal Assessment Battery (FAB)dual taskexecutive dysfunctionneuropsychiatric symptomsNeuropsychiatric Inventory (NPI)
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 5 , October 2008 , pp. 964 - 975
Copyright
Copyright © International Psychogeriatric Association 2008

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References

Amieva, H. Phillips, L. H. Della Sala, S. and Henry, J. D. (2004). Inhibitory functioning in Alzheimer's disease. Brain, 127, 949–964.CrossRefGoogle ScholarPubMed
Baddeley, A. Della Sala, S. Papagno, C. and Spinnler, H. (1997). Dual-task performance in dysexecutive and nondysexecutive patients with a frontal lesion. Neuropsychology, 11, 187–194.CrossRefGoogle ScholarPubMed
Castiglioni, S. et al. (2006). The frontal assessment battery does not differentiate frontotemporal dementia from Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 22, 125–131.CrossRefGoogle Scholar
Cummings, J. L. Mega, M. Gray, K. Rosenberg-Thompson, S. Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Dubois, B. Slachevsky, A. Litvan, I. and Pillon, B. (2000). The FAB: a Frontal Assessment Battery at bedside. Neurology, 55, 1621–1626.CrossRefGoogle ScholarPubMed
Folstein, M. F. Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Harrison, B. J. et al. (2005). Functional connectivity during Stroop task performance. Neuroimage, 24, 181–191.CrossRefGoogle ScholarPubMed
Hirono, N. et al. (1997). Japanese version of the Neuropsychiatric Inventory: a scoring system for neuropsychiatric disturbance in dementia patients [in Japanese]. No To Shinkei, 49, 266–271.Google ScholarPubMed
Hirono, N. et al. (1998). Frontal lobe hypometabolism and depression in Alzheimer's disease. Neurology, 50, 380–383.CrossRefGoogle ScholarPubMed
Holthoff, V. A. et al. (2005). Regional cerebral metabolism in early Alzheimer's disease with clinically significant apathy or depression. Biological Psychiatry, 57, 412–421.CrossRefGoogle ScholarPubMed
Hughes, C. P. Berg, L. Danziger, W. L. Coben, L. A. and Martin, R. L. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566–572.CrossRefGoogle ScholarPubMed
Kuzis, G. Sabe, L. Tiberti, C. Dorrego, F. and Starkstein, S. E. (1999). Neuropsychological correlates of apathy and depression in patients with dementia. Neurology, 52, 1403–1407.CrossRefGoogle ScholarPubMed
Lipton, A. M. Ohman, K. A. Womack, K. B. Hynan, L. S. Ninman, E. T. and Lacritz, L. H. (2005). Subscores of the FAB differentiate frontotemporal lobar degeneration from AD. Neurology, 65, 726–731.CrossRefGoogle ScholarPubMed
Lockwood, K. A. Alexopoulos, G. S. and van Gorp, W. G. (2002). Executive dysfunction in geriatric depression. American Journal of Psychiatry, 159, 1119–1126.CrossRefGoogle ScholarPubMed
Logie, R. H. Cocchini, G. Della Sala, S. and Baddeley, A. D. (2004). Is there a specific executive capacity for dual task coordination? Evidence from Alzheimer's disease. Neuropsychology, 18, 504–513.CrossRefGoogle Scholar
Loose, R. Kaufmann, C. Auer, D. P. and Lange, K. W. (2003). Human prefrontal and sensory cortical activity during divided attention tasks. Human Brain Mapping, 18, 249–259.CrossRefGoogle ScholarPubMed
Lopez, O. L. Becker, J. T. Reynolds, C. F. III Jungreis, C. A. Weinman, S. and DeKosky, S. T. (1997). Psychiatric correlates of MR deep white matter lesions in probable Alzheimer's disease. Journal of Neuropsychiatry and Clinical Neurosciences, 9, 246–250.Google ScholarPubMed
McKhann, G. Drachman, D. Folstein, M. Katzman, R. Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
McPherson, S. Fairbanks, L. Tiken, S. Cummings, J. L. and Back-Madruga, C. (2002). Apathy and executive function in Alzheimer's disease. Journal of the International Neuropsychological Society, 8, 373–381.CrossRefGoogle ScholarPubMed
Nakaaki, S. et al. (2007a). Greater impairment of ability in the divided attention task is seen in Alzheimer's disease patients with depression than in those without depression. Dementia and Geriatric Cognitive Disorders, 23, 231–240.CrossRefGoogle ScholarPubMed
Nakaaki, S. et al. (2007b). Reliability and validity of the Japanese version of the Frontal Assessment Battery in patients with the frontal variant of frontotemporal dementia. Psychiatry and Clinical Neurosciences, 61, 78–83.CrossRefGoogle ScholarPubMed
Nebes, R. D. et al. (2001). Dual-task performance in depressed geriatric patients. Psychiatry Research, 102, 139–151.CrossRefGoogle ScholarPubMed
Slachevsky, A. Villalpando, J. M. Sarazin, M. Hahn-Barma, V. Pillon, B. and Dubois, B. (2004). Frontal assessment battery and differential diagnosis of frontotemporal dementia and Alzheimer disease. Archives of Neurology, 61, 1104–1107.CrossRefGoogle ScholarPubMed
SPSS Inc. (2001). SPSS for Windows Version 11.0. Chicago: SPSS Inc.Google Scholar
Starkstein, S. E. Ingram, L. Garau, M. L. and Mizrahi, R. (2005). On the overlap between apathy and depression in dementia. Journal of Neurology, Neurosurgery, and Psychiatry, 76, 1070–1074.CrossRefGoogle ScholarPubMed
Stokholm, J. Vogel, A. Gade, A. and Waldemar, G. (2006). Heterogeneity in executive impairment in patients with very mild Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 22, 54–59.CrossRefGoogle ScholarPubMed
Swanberg, M. M. Tractenberg, R. E. Mohs, R. Thal, L. J. and Cummings, J. L. (2004). Executive dysfunction in Alzheimer disease. Archives of Neurology, 61, 556–560.CrossRefGoogle ScholarPubMed
Tekin, S. Fairbanks, L. A. O'Connor, S. Rosenberg, S. and Cummings, J. L. (2001). Activities of daily living in Alzheimer's disease: neuropsychiatric, cognitive, and medical illness influences. American Journal of Geriatric Psychiatry, 9, 81–86.CrossRefGoogle ScholarPubMed
Vilalta-Franch, J. et al. (2006). Comparison of different clinical diagnostic criteria for depression in Alzheimer disease. American Journal of Geriatric Psychiatry, 14, 589–597.CrossRefGoogle ScholarPubMed
Williams, J. B. (1988). A structured interview guide for the Hamilton depression scale. Archives of General Psychiatry, 45, 742–747.CrossRefGoogle Scholar