Apathy, depression, and dementia risk in older adults: A global collaborative study

초록

INTRODUCTION: The role of apathy in predicting dementia risk, especially with coexisting depression, remains unclear in community-dwelling older adults. METHODS: We analyzed data from 12,646 older adults without baseline dementia across ten population-based cohorts from six continents (Cohort Studies of Memory in an International Consortium study). Apathy, depression, and dementia outcomes were assessed using harmonization protocols. RESULTS: Over 5.7 years of follow-up, 1160 developed dementia and 552 Alzheimer's disease (AD). Apathy prevalence was 34.1% and more than three times higher in those with depression. Apathy was not associated with dementia risk among cognitively normal or non-depressed individuals. In contrast, among individuals with depression and mild cognitive impairment (MCI), apathy predicted a higher risk of dementia (hazard ratio [HR] 1.62) and AD (HR 1.74). DISCUSSION: Apathy is associated with increased dementia risk only in older adults withMCIand depression. Findings highlight the need to incorporate affective symptom monitoring into dementia risk assessment and intervention.

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