Krushnaa Sankhe, Shankar Tumati, Jamie Perin, Luc Rivet, Danielle Vieira, Paul B Rosenberg, Nathan Herrmann, David Shade, Alan J Lerner, Prasad R Padala, Olga Brawman-Mintzer, Christopher H van Dyck, Anton P Porsteinsson, Suzanne Craft, Allan I Levey, Jacobo Mintzer, Krista L Lanctôt
{"title":"阿尔茨海默病相关性冷漠改变与认知的相关性：失智症患者冷漠试验2 （ADMET 2）分析","authors":"Krushnaa Sankhe, Shankar Tumati, Jamie Perin, Luc Rivet, Danielle Vieira, Paul B Rosenberg, Nathan Herrmann, David Shade, Alan J Lerner, Prasad R Padala, Olga Brawman-Mintzer, Christopher H van Dyck, Anton P Porsteinsson, Suzanne Craft, Allan I Levey, Jacobo Mintzer, Krista L Lanctôt","doi":"10.1016/j.inpsyc.2024.100012","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Previous trials have shown improvements in both apathy and cognition with methylphenidate (MPH).</p><p><strong>Objectives: </strong>To assess whether changes in apathy correlated with changes in cognition in the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2).</p><p><strong>Participants: </strong>Mild to moderate AD patients with clinically significant apathy randomized to MPH (20 mg/day) or placebo for 6 months.</p><p><strong>Measurements: </strong>Apathy was measured with the Neuropsychiatric Inventory-apathy (NPI-A) domain. Cognition was measured using the Mini-Mental State Exam (MMSE), Hopkins Verbal Learning (immediate [HVLT-I], delayed [HVLT-D] recall), Digit Span (Forward [DF], Backward [DB]), Trail Making (TMT-A, TMT-B), Action Verbal Fluency (AV), Category Fluency (CF), and the Short Boston Naming Test (BNT).</p><p><strong>Design: </strong>Linear mixed models included cognitive change scores as dependent variables and time, treatment, change in NPI-A and the interaction between treatment and change in NPI-A as independent variables, which were additionally adjusted for baseline NPI-A and cognitive scores, age, sex, level of education and presence of diabetes.</p><p><strong>Results: </strong>199 participants (66 % male) were included (98-MPH, 101-placebo). Among all participants, worsening CF was associated with worsening apathy (-0.15 (0.05), p = .003). In addition, change in HVLT-I was associated with the interaction between changes in apathy and treatment (-0.31 (0.07), p = 0.0000158).</p><p><strong>Conclusion: </strong>Changes in apathy are mostly independent of cognitive changes and apathy response to MPH may be independent from cognition. These results are consistent with the view that apathy as a syndrome is related to but distinct from cognition.</p>","PeriodicalId":14368,"journal":{"name":"International psychogeriatrics","volume":"37 2","pages":"100012"},"PeriodicalIF":4.6000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Correlation between changes in apathy and cognition in Alzheimer's disease associated apathy: Analysis of the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2).\",\"authors\":\"Krushnaa Sankhe, Shankar Tumati, Jamie Perin, Luc Rivet, Danielle Vieira, Paul B Rosenberg, Nathan Herrmann, David Shade, Alan J Lerner, Prasad R Padala, Olga Brawman-Mintzer, Christopher H van Dyck, Anton P Porsteinsson, Suzanne Craft, Allan I Levey, Jacobo Mintzer, Krista L Lanctôt\",\"doi\":\"10.1016/j.inpsyc.2024.100012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Previous trials have shown improvements in both apathy and cognition with methylphenidate (MPH).</p><p><strong>Objectives: </strong>To assess whether changes in apathy correlated with changes in cognition in the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2).</p><p><strong>Participants: </strong>Mild to moderate AD patients with clinically significant apathy randomized to MPH (20 mg/day) or placebo for 6 months.</p><p><strong>Measurements: </strong>Apathy was measured with the Neuropsychiatric Inventory-apathy (NPI-A) domain. Cognition was measured using the Mini-Mental State Exam (MMSE), Hopkins Verbal Learning (immediate [HVLT-I], delayed [HVLT-D] recall), Digit Span (Forward [DF], Backward [DB]), Trail Making (TMT-A, TMT-B), Action Verbal Fluency (AV), Category Fluency (CF), and the Short Boston Naming Test (BNT).</p><p><strong>Design: </strong>Linear mixed models included cognitive change scores as dependent variables and time, treatment, change in NPI-A and the interaction between treatment and change in NPI-A as independent variables, which were additionally adjusted for baseline NPI-A and cognitive scores, age, sex, level of education and presence of diabetes.</p><p><strong>Results: </strong>199 participants (66 % male) were included (98-MPH, 101-placebo). Among all participants, worsening CF was associated with worsening apathy (-0.15 (0.05), p = .003). In addition, change in HVLT-I was associated with the interaction between changes in apathy and treatment (-0.31 (0.07), p = 0.0000158).</p><p><strong>Conclusion: </strong>Changes in apathy are mostly independent of cognitive changes and apathy response to MPH may be independent from cognition. These results are consistent with the view that apathy as a syndrome is related to but distinct from cognition.</p>\",\"PeriodicalId\":14368,\"journal\":{\"name\":\"International psychogeriatrics\",\"volume\":\"37 2\",\"pages\":\"100012\"},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International psychogeriatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.inpsyc.2024.100012\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International psychogeriatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.inpsyc.2024.100012","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/4 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Correlation between changes in apathy and cognition in Alzheimer's disease associated apathy: Analysis of the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2).
Background: Previous trials have shown improvements in both apathy and cognition with methylphenidate (MPH).
Objectives: To assess whether changes in apathy correlated with changes in cognition in the Apathy in Dementia Methylphenidate Trial 2 (ADMET 2).
Participants: Mild to moderate AD patients with clinically significant apathy randomized to MPH (20 mg/day) or placebo for 6 months.
Measurements: Apathy was measured with the Neuropsychiatric Inventory-apathy (NPI-A) domain. Cognition was measured using the Mini-Mental State Exam (MMSE), Hopkins Verbal Learning (immediate [HVLT-I], delayed [HVLT-D] recall), Digit Span (Forward [DF], Backward [DB]), Trail Making (TMT-A, TMT-B), Action Verbal Fluency (AV), Category Fluency (CF), and the Short Boston Naming Test (BNT).
Design: Linear mixed models included cognitive change scores as dependent variables and time, treatment, change in NPI-A and the interaction between treatment and change in NPI-A as independent variables, which were additionally adjusted for baseline NPI-A and cognitive scores, age, sex, level of education and presence of diabetes.
Results: 199 participants (66 % male) were included (98-MPH, 101-placebo). Among all participants, worsening CF was associated with worsening apathy (-0.15 (0.05), p = .003). In addition, change in HVLT-I was associated with the interaction between changes in apathy and treatment (-0.31 (0.07), p = 0.0000158).
Conclusion: Changes in apathy are mostly independent of cognitive changes and apathy response to MPH may be independent from cognition. These results are consistent with the view that apathy as a syndrome is related to but distinct from cognition.
期刊介绍：
A highly respected, multidisciplinary journal, International Psychogeriatrics publishes high quality original research papers in the field of psychogeriatrics. The journal aims to be the leading peer reviewed journal dealing with all aspects of the mental health of older people throughout the world. Circulated to over 1,000 members of the International Psychogeriatric Association, International Psychogeriatrics also features important editorials, provocative debates, literature reviews, book reviews and letters to the editor.
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