| Full text | |
| Author(s): |
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
|
| Affiliation: | [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 |
| Abstract | |
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: | 09/53778-3 - SABE Study 2010: Health, well-being and aging |
| Grantee: | Maria Lúcia Lebrão |
| Support Opportunities: | Research Projects - Thematic Grants |
| FAPESP's process: | 99/05125-7 - As condicoes de saude dos idosos na america latina e caribe. |
| Grantee: | Ruy Laurenti |
| Support Opportunities: | Regular Research Grants |
| 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 Opportunities: | Research Projects - Thematic Grants |