背景:冷漠被定义为缺乏动机,并且已被发现与西方人群的痴呆事件有关(达伦,2018)。人们对冷漠对亚洲人的影响知之甚少。冷漠是痴呆前的一种普遍行为症状,目前的文献表明,冷漠会增加痴呆的风险(Bock,2020)。冷漠也与虚弱的风险增加有关(艾尔斯,2018年),并发现会损害执行功能和处理速度(Lohner,2017)。我们的目的是评估冷漠与认知功能的关系,新加坡痴呆前社区人群的虚弱和生活方式因素。
方法:我们从社区招募了534名参与者,他们完成了详细的神经心理学评估。使用轻度行为障碍检查表(MBI-C)测量冷漠。为了测试冷漠与不同变量的关联,我们对协变量年龄进行了多重广义线性模型控制,性和教育。
结果:研究人群包括186名主观认知功能减退的参与者和348名来自新加坡痴呆症研究中心的轻度认知功能减退的参与者。该队列的平均年龄为62.55,SD=9.55,平均教育年限为13.97,SD=3.45,大多数为女性(57.1%)。在我们的队列中,冷漠的患病率为23.5%。与没有冷漠的参与者相比,冷漠的人在处理速度(编码测试)上的认知评分较差(β=-4.60,p<0.001),执行功能(颜色轨迹2)(β=9.71,p=0.020),RAVLT延迟的情景记忆(β=-0.738,p=0.026),RCFT延迟(β=-1.941,p=0.009)和FCSRT延迟(β=-0.616,p=0.030)。在Fried表型虚弱评估测试中,冷漠的参与者也更虚弱(β=0.316,p<0.001),生活质量较差(β=-12.49,p<0.001),体力活动水平较低(β=0.163,p=0.017),睡眠较差(β=2.25,p<0.001)。
结论:冷漠与较差的认知表现有关,更脆弱,在一个亚洲痴呆前社区队列中,较低的身体表现和较差的睡眠。筛查冷漠和适当的早期干预可以减少痴呆和虚弱的发生率。
BACKGROUND: Apathy is defined as the lack of motivation and has been found to be associated with incident dementia in western populations (Dalen, 2018). Little is known about the impact of
apathy in Asians.
Apathy is a prevalent behavioural symptom of pre dementia and current literature shows that
apathy increases the risk of dementia (Bock, 2020). Apathy is also linked to an increased risk of frailty(Ayers, 2018) and found to impair executive function and processing speed(Lohner, 2017). We aim to evaluate the association of apathy with cognitive function, frailty and lifestyle factors in a pre-dementia community population in Singapore.
METHODS: We recruited 534 participants from the community who completed a detailed neuropsychological assessment.
Apathy was measured using the mild behavioural impairment checklist (MBI-C). To test for the association of apathy with the different variables, we performed a multiple generalized linear model controlling for covariates age, sex and education.
RESULTS: The study population included 186 participants with subjective cognitive decline and 348 mild cognitive impairment participants from Dementia Research Centre (Singapore). Mean age of the cohort was 62.55, SD = 9.55, mean education years was 13.97, SD = 3.45 and majority were women (57.1%). The prevalence of
apathy among our cohort was 23.5%. Compared to participants without
apathy, those with
apathy had poorer cognitive scores in processing speed (test of coding) (β = -4.60, p<0.001), executive function (colour trails 2) (β = 9.71, p = 0.020), episodic memory on the RAVLT Delayed (β = -0.738, p = 0.026), RCFT Delayed (β = -1.941, p = 0.009) and FCSRT delayed (β = -0.616, p = 0.030). Participants with apathy were also more frail (β = 0.316, p<0.001) on the Fried Phenotype frailty assessment test and had poorer quality of life (β = -12.49, p<0.001), had lower levels of physical activity (β = 0.163, p = 0.017), and had poorer sleep (β = 2.25, p<0.001).
CONCLUSIONS: Apathy is associated with worse cognitive performance, higher frailty, lower physical performance and poorer sleep in an Asian pre-dementia community cohort. Screening for apathy and appropriate early intervention could reduce incidence of dementia and frailty.