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Am J Geriatr Psychiatry. 2013 Apr;21(4):391-7. doi: 10.1016/j.jagp.2012.12.012. Epub 2013 Feb 6.

Phenotyping apathy in individuals with Alzheimer disease using functional principal component analysis.

Author information

1
Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA; Psychiatry Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA. Electronic address: jzeitzer@stanford.edu.

Abstract

OBJECTIVES:

To determine if there is a specific pattern of gross motor activity associated with apathy in individuals with Alzheimer disease (AD).

DESIGN:

Examination of ad libitum 24-hour ambulatory gross motor activity patterns.

SETTING:

Community-dwelling, outpatient.

PARTICIPANTS:

Ninety-two individuals with AD, 35 of whom had apathy.

MEASUREMENTS:

Wrist actigraphy data were collected and examined using functional principal component analysis (fPCA).

RESULTS:

Individuals with apathy have a different pattern of gross motor activity than those without apathy (first fPCA component, p <0.0001, t = 5.73, df = 90, t test) such that there is a pronounced decline in early afternoon activity in those with apathy. This change in activity is independent of depression (p = 0.68, F[1, 89] = 0.05, analysis of variance). The decline in activity is consistent with an increase in napping. Those with apathy also have an early wake and bedtime (second fPCA component, t = 2.53, df = 90, p <0.05, t test).

CONCLUSIONS:

There is a signature activity pattern in individuals with apathy and AD that is distinct from those without apathy and those with depression. Actigraphy may be a useful adjunctive measurement in the clinical diagnosis of apathy in the context of AD.

PMID:
23498386
PMCID:
PMC3603283
DOI:
10.1016/j.jagp.2012.12.012
[Indexed for MEDLINE]
Free PMC Article
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