Research published in the Journal of Neuropsychiatry and Clinical Sciences showed a strong correlation between apathy and physical, cognitive, and behavioral dysfunction across disease stages in patients with Huntington disease (HD).
Researchers collected data from the baseline visits of 487 individuals with the HD mutation (prodromal, n=193; early-stage manifest, n=186; late-stage manifest, n=108). Study data captured clinician-rated measures of physical, cognitive, and behavioral function and self-reported measures of physical function, health-related quality of life, and emotional, cognitive, and social function. Clinicians also assessed apathy levels in participants per the Problem Behaviors Assessment.
Across 3 HD disease stages, the average Problem Behaviors Assessment apathy score was 2.5 (standard deviation, 4.0). The prodromal group had an average score of 1.4 (standard deviation, 2.9), which was significantly lower than both that of the early-stage (mean, 3.0; standard deviation, 4.1) and late-stage (mean, 3.9; standard deviation, 5.0) disease groups (P <.0001). For clinician-rated measures, better behavioral status was associated with better apathy scores (P <.0001), although there was no association between apathy and clinician-rated cognition, functioning, or physical ability. For self-reported health-related quality of life, better scores on the generic composite measure (P =.0201), emotional status (P <.0001), cognition (P <.0001), and social functioning (P <.0001) were significantly associated with better apathy outcomes.
Within these measures, apathy was specifically associated with greater chorea; greater extremity dysfunction; greater speech and swallowing dysfunction; worse anxiety, depression, and behavioral dyscontrol; worse cognitive function; and less satisfaction with social roles.
These data confirm the debilitating effects of apathy on functioning in patients with HD. Investigators suggested future studies to examine the efficacy of clinical interventions on apathy reduction in patients with HD.
Fritz NE, Boileua NR, Stout JC, et al. Relationships among apathy, health-related quality of life, and function in Huntington’s disease [published online March 21, 2018]. J Neuropsychiatry Clin Neurosci. doi: 10.1176/appi.neuropsych.17080173