Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-22T17:35:48.252Z Has data issue: false hasContentIssue false

Actigraphic Daytime Activity is Reduced in Patients With Cognitive Impairment and Apathy

Published online by Cambridge University Press:  21 June 2011

A. Kuhlmei*
Affiliation:
Bethesda Geriatrische Klinik Ulm, Zollernring 26, 89073Ulm, Germany Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Straβe 2, 89312Günzburg, Germany
B. Walther
Affiliation:
Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Straβe 2, 89312Günzburg, Germany
T. Becker
Affiliation:
Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Straβe 2, 89312Günzburg, Germany
U. Müller
Affiliation:
The Cambridge Behavioural and Clinical Neuroscience Institute (BCNI), Departments of Experimental Psychology and Psychiatry, Downing Site, CambridgeCB2 3EB, United Kingdom
T. Nikolaus
Affiliation:
Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Straβe 2, 89312Günzburg, Germany
*
Corresponding author. E-mail address: [email protected] (A. Kuhlmei).
Get access

Abstract

Objectives

Apathy is a neuropsychiatric symptom in mild cognitive impairment (MCI) and dementia. This study examines correlations between Apathy Evaluation Scale (AES) ratings and actigraphic measures of daytime activity. The aim of this study is to determine the value of ambulatory actigraphy in the assessment of locomotor deficits as a correlate of apathy in geriatric patients with cognitive impairment.

Patients and methods

In this cross-sectional study a total of 82 participants were recruited, 32 patients with dementia, 21 patients with MCI and 23 elderly controls. Rating scales for apathy (AES) and depression (Beck Depression Inventory, BDI) were completed. To measure daytime activity a wrist-worn actigraph and an established protocol were used. A single measure of mean daytime activity per participant was calculated for further statistical analysis.

Results

In the two groups of patients with MCI and dementia, apathy is associated with reduced daytime activity, independent of diagnosis (no group by apathy interaction). AES scores correlate significantly with daytime activity. Cognitive impairment reduces daytime activity (effect greater in dementia than in MCI). Daytime activity is negatively correlated with memory deficits.

Conclusion

Ambulatory actigraphy is a promising method to evaluate self-initiated action as a correlate of apathy in patients with cognitive impairment.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alessi, C.A., Martin, J.L., Webber, A.P., Cynthia, K.E., Harker, J.O., Josephson, K.R.Randomized, controlled trial of a nonpharmacological intervention to improve abnormal sleep/wake patterns in nursing home residents. J Am Geriatr Soc 2005;53(5):803810.CrossRefGoogle ScholarPubMed
Andersson, S., Gundersen, P.M., Finset, A.Emotional activation during therapeutic interaction in traumatic brain injury: effect of apathy, self-awareness and implications for rehabilitation. Brain Inj 1999;13(6):393404.CrossRefGoogle ScholarPubMed
Bruck, D., Kennedy, G.A., Cooper, A., Apel, S.Diurnal actigraphy and stimulant efficacy in narcolepsy. Hum Psychopharmacol 2005;20(2):105113.CrossRefGoogle ScholarPubMed
Cummings, J.L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D.A., Gornbein, J.The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44(12):23082314.CrossRefGoogle ScholarPubMed
Dane, A.V., Schachar, R.J., Tannock, R.Does actigraphy differentiate ADHD subtypes in a clinical research setting?. J Am Acad Child Adolesc Psychiatry 2000;39(6):752760.Google Scholar
Deb, S., Crownshaw, T.The role of pharmacotherapy in the management of behaviour disorders in traumatic brain injury patients. Brain Inj 2004;18(1):131.CrossRefGoogle ScholarPubMed
Glenn, M.B., Burke, D.T., O’Neil-Pirozzi, T., Goldstein, R., Jacob, L., Kettell, J.Cutoff score on the apathy evaluation scale in subjects with traumatic brain injury. Brain Inj 2002;16(6):509516.CrossRefGoogle ScholarPubMed
Harper, D.G., Stopa, E.G., McKee, A.C., Satlin, A., Harlan, P.C., Goldstein, R.et al.Differential circadian rhythm disturbances in men with Alzheimer disease and frontotemporal degeneration. Arch Gen Psychiatry 2001;58(4):353360.CrossRefGoogle ScholarPubMed
Hatfield, C.F., Herbert, J., Van Someren, E.J., Hodges, J.R., Hastings, M.H.Disrupted daily activity/rest cycles in relation to daily cortisol rhythms of home-dwelling patients with early Alzheimer's dementia. Brain 2004;127(Pt 5):10611074.CrossRefGoogle ScholarPubMed
Kant, R., Duffy, J.D., Pivovarnik, A.Prevalence of apathy following head injury. Brain Inj 1998;12(1):8792.CrossRefGoogle ScholarPubMed
Kiang, M., Christensen, B.K., Remington, G., Kapur, S.Apathy in schizophrenia: clinical correlates and association with functional outcome. Schizophr Res 2003;63(1–2):7988.CrossRefGoogle ScholarPubMed
Lemke, M.R., Puhl, P., Broderick, A.Motor activity and perception of sleep in depressed patients. J Psychiatr Res 1999;33(3):215224.Google ScholarPubMed
Lueken, U., Seidl, U., Schwarz, M., Volker, L., Naumann, D., Mattes, K.et al.Psychometric properties of a German version of the Apathy Evaluation Scale. Fortschr Neurol Psychiatr 2006;74(12):714722.CrossRefGoogle ScholarPubMed
Marin, R.S., Biedrzycki, R.C., Firinciogullari, S.Reliability and validity of the Apathy Evaluation Scale. Psychiatry Res 1991;38(2):143162.CrossRefGoogle ScholarPubMed
Marin, R.S., Wilkosz, P.A.Disorders of diminished motivation. J Head Trauma Rehabil 2005;20(4):377388.CrossRefGoogle ScholarPubMed
Martin, J., Jeste, D.V., Caliguiri, M.P., Patterson, T., Heaton, R., Ancoli-Israel, S.Actigraphic estimates of circadian rhythms and sleep/wake in older schizophrenia patients. Schizophr Res 2001;47(1):7786.Google ScholarPubMed
McAllister, T.W.Apathy. Semin Clin Neuropsychiatry 2000;5(4):275282.CrossRefGoogle ScholarPubMed
Muller, U., Czymmek, J., Thone-Otto, A., Von Cramon, D.Y.Reduced daytime activity in patients with acquired brain damage and apathy: a study with ambulatory actigraphy. Brain Inj 2006;20(2):157160.CrossRefGoogle ScholarPubMed
Paavilainen, P., Korhonen, I., Lotjonen, J., Cluitmans, L., Jylha, M., Sarela, A.et al.Circadian activity rhythm in demented and non-demented nursing-home residents measured by telemetric actigraphy. J Sleep Res 2005;14(1):6168.CrossRefGoogle ScholarPubMed
Petersen, R.C., Smith, G.E., Waring, S.C., Ivnik, R.J., Tangalos, E.G., Kokmen, E.Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56(3):303308.Google ScholarPubMed
Robert, P., Onyike, C.U., Leentjens, A.F., Dujardin, K., Aalten, P., Starkstein, S.et al.Proposed diagnostic criteria for apathy in Alzheimer's disease and other neuropsychiatric disorders. Eur Psychiatry 2009;24(2):98104.CrossRefGoogle ScholarPubMed
Sadeh, A., Acebo, C.The role of actigraphy in sleep medicine. Sleep Med Rev 2002;6(2):113124.CrossRefGoogle ScholarPubMed
Stuss, D.T.v.R.R.M.K.Differentiation of states and causes of apathy. In: Borod, J.C. editor.The neuropsychology of emotion. Oxford: Oxford University Press; 2000. 340363.Google Scholar
Volicer, L., Harper, D.G., Manning, B.C., Goldstein, R., Satlin, A.Sundowning and circadian rhythms in Alzheimer's disease. Am J Psychiatry 2001;158(5):704711.CrossRefGoogle ScholarPubMed
Winkler, D., Pjrek, E., Praschak-Rieder, N., Willeit, M., Pezawas, L., Konstantinidis, A.et al.Actigraphy in patients with seasonal affective disorder and healthy control subjects treated with light therapy. Biol Psychiatry 2005;58(4):331336.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.