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The following is a summary of “Incidence, Symptom Trajectory, and Impact on Quality of Life and Disability,” published in the January 2024 issue of Neurology by Pallucca et al.
Researchers conducted a retrospective study to chart the trajectory of apathy symptoms from stroke onset to one year later, along with its ties to disability and quality of life, both individually and concerning depression.
They assessed apathy in ischemic stroke survivors at four time points (0 to 12 months post-stroke). The Apathy Evaluation Scale (AES) and Dimensional Apathy Scale (DAS) were administered at each point in time, with carers providing apathy measurements where possible. Depression was evaluated using the Geriatric Depression Scale (GDS). Disability and QoL were measured using the modified Rankin Scale (mRS) and 36-Item Short Form Survey (SF-36). Analyzed apathy in stroke survivors, examining associations with post-stroke depression and one-year mRS/SF-36 outcomes.
The results showed 200 participants and 165 completed apathy assessments (12-month mark). Group-level increases were observed in patient-rated apathy scores for both AES (χ2(3) = 9.86, P=0.019) and DAS (χ2(3) = 8.49, P=0.037), as well as at the individual level (AES: β = 0.13, P=0.002; DAS: β = 0.13, P=0.005; DAS executive: β = 0.08, P<0.001). Carer-rated apathy did not show a significant increase (AES: χ2(3) = 0.75, P=0.862; DAS: χ2(3) = 2.45, P=0.484). Apathy scores were associated with worse mRS and SF-36. Many associations lost significance when accounting for depression. GDS remained linked to worse mRS and SF-36 even after adjusting for covariates and apathy (mRS: β = 0.08, P=0.006; SF-36 Mental Component Summary: β = −1.53, P<0.001; SF-36 Physical Component Summary: β = −0.57, P=0.016).
They concluded that apathy’s post-stroke rise, linked to poorer quality of life and disability, was driven by executive dysfunction and, possibly, depression.