Objective: To investigate the demographic and clinical correlates of apathy in a group of patients from a Movement Disorders clinic in Latin America.

Background: Apathy is a common non-motor symptom affecting almost 40% of patients with Parkinson’s disease and has been associated with a higher burden of the disease and poorer quality of life. It has even been proposed as a risk factor for motor complications and cognitive impairment. No specific or effective treatments are currently available and its pathophysiology has not been completely elucidated. Data on patients from South America, and their possible particular traits, is lacking.

Method: We examined a series of 28 patients that volunteered for participation on a longitudinal study for the study of cognitive and psychiatric impairment in PD. Neurological examination and cognitive evaluation were performed trough Starkstein’s apathy scale, Parkinson´s anxiety scale, MOCA, MDS-UPDRS. We performed two-tailed Mann Whitney U test to compare an apathetic and a non-apathetic group (as per Starkstein’s scale).

Results: Half of the recruited patients resulted to be apathetic. Although it did not reach statistical significance, the apathetic group seemed to have a longer disease duration (with median values of 46 vs 80 months, p 0.07). Our apathetic group resulted to be older than the non-apathetic (68.5 non-apathetic vs 75.5 years apathetic group, p 0.011). We did not find differences in their motor scores (MDS-UPDRS III of 31 vs 34.5, p 0.289) or LED (561 vs 692.5, p 0.423). We did not find statistically significant differences in Beck depression scores in these patients (8.5 vs 9.5, p 0.535), and the apathetic group resulted to score higher on anxiety scales (7.5 vs 14, p 0.01). Cognitive evaluation showed no statistically significant differences between the non-apathetic and apathetic groups (median MOCA values of 26 vs 22, p 0.07).

Conclusion: Apathy seems to be a very frequent complication in our population, and seemed to be unrelated to the co-occurrence of depression or cognitive impairment. Apathetic parkinsonian patients in our cohort seemed to be older and more anxious. There was not a statistically significant relationship with motor scores. Apathy seems to not be just a trait of disease progression, but an independent neuropsychiatric syndrome.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-correlates-of-apathy-in-parkinsons-disease/