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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Apathy and depressive symptoms in older people and incident myocardial infarction, stroke, and mortality: a systematic review and meta-analysis of individual participant data

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Eurelings, Lisa S. M. [1] ; van Dalen, Jan Willem [1] ; ter Riet, Gerben [2] ; van Charante, Eric P. Moll [2] ; Richard, Edo [1, 3] ; van Gool, Willem A. [1] ; Grp, ICARA Study
Total Authors: 7
[1] Univ Amsterdam, Acad Med Ctr, Dept Neurol, 9 Meibergdreef, NL-1100 DD Amsterdam - Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Gen Practice, Amsterdam - Netherlands
[3] Radboud Univ Nijmegen, Med Ctr, Dept Neurol, Donders Inst Brain Cognit & Behav, Nijmegen - Netherlands
Total Affiliations: 3
Document type: Review article
Source: CLINICAL EPIDEMIOLOGY; v. 10, p. 363-379, 2018.
Web of Science Citations: 8

Background: Previous findings suggest that apathy symptoms independently of depressive symptoms measured using the Geriatric Depression Scale (GDS) are associated with cardiovascular disease (CVD) in older individuals. Aims: To study whether apathy and depressive symptoms in older people are associated with future CVD, stroke, and mortality using individual patient-data meta-analysis. Methods: Medline, Embase, and PsycInfo databases up to September 3, 2013, were systematically searched without language restrictions. We sought prospective studies with older (mean age >= 65 years) community-dwelling populations in which the GDS was employed and subsequent stroke and/or CVD were recorded to provide individual participant data. Apathy symptoms were defined as the three apathy-related subitems of the GDS, with depressive symptoms the remaining items. We used myocardial infarction (MI), stroke, and all-cause mortality as main outcomes. Analyses were adjusted for age, sex, and MI/stroke history. An adaptation of the Newcastle-Ottawa scale was used to evaluate bias. Hazard ratios were calculated using onestage random-effect Cox regression models. Results: Of the 52 eligible studies, 21 (40.4%) were included, comprising 47,625 older people (mean age {[}standard deviation] 74 {[}7.4] years), over a median follow-up of 8.8 years. Participants with apathy symptoms had a 21% higher risk of MI (95% confidence interval {[}CI] 1.08-1.36), a 37% higher risk of stroke (95% CI 1.18-1.59), and a 47% higher risk of all-cause mortality (95% CI 1.38-1.56). Participants with depressive symptoms had a comparably higher risk of stroke (HR 1.36, 95% CI 1.18-1.56) and all-cause mortality (HR 1.44, 95% CI 1.35-1.53), but not of MI (HR 1.08, 95% CI 0.91-1.29). Associations for isolated apathy and isolated depressive symptoms were comparable. Sensitivity analyses according to risk of bias yielded similar results. Conclusion: Our findings stress the clinical importance of recognizing apathy independently of depressive symptoms, and could help physicians identify persons at increased risk of vascular disease. (AU)

FAPESP's process: 05/54947-2 - SABE study - 2005: well-being and ageing: longitudinal study of living conditions and health of elderly in the municipality of São Paulo
Grantee:Ruy Laurenti
Support type: Research Projects - Thematic Grants
FAPESP's process: 09/53778-3 - SABE Study –2010: Health, well-being and aging
Grantee:Maria Lúcia Lebrão
Support type: Research Projects - Thematic Grants