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- Title
Apathy: Risk Factor for Mortality in Nursing Home Patients.
- Authors
Nijsten, Johanna M. H.; Leontjevas, Ruslan; Pat ‐ El, Ron; Smalbrugge, Martin; Koopmans, Raymond T. C. M.; Gerritsen, Debby L.
- Abstract
Objectives To determine the prognostic value of apathy for mortality in patients of somatic ( SC) and dementia special care ( DSC) nursing home ( NH) units. Design Longitudinal design, secondary analyses of a 2-year, cluster-randomized trial with six measurements, approximately 4 months in between. Setting SC and DSC-units of Dutch NHs. Participants NH-patients of seventeen SC-units (n = 342) and sixteen DCS-units (n = 371). Measurements Data were available for 713 NH-patients, 266 of whom died during the study. Apathy was assessed using the 10-item Apathy Evaluation Scale ( AES-10) and applied as categorical variable using known cut-off scores as well as dimensional variable. Additionally, depressive symptoms were assessed using the Cornell Scale for Depression in Dementia. Results Mixed effects cox models using the coxme package in R revealed a higher risk of mortality between two measurements, if apathy was present (hazard ratio ( HR) = 1.77; 95% confidence interval ( CI] = 1.35-2.31, P < .001). Results remained significant ( HR = 1.64; 95% CI = 1.23-2.19, P < .001) when controlled for depressive symptoms. DSC-units and SC-units did not differ ( P > .05) in the effect of apathy on mortality. Male gender ( HR = 1.67; 95% CI = 1.23-2.27, P < .001), and higher age in years ( HR = 1.06; 95% CI = 1.04-1.08, P < .001) were also predictors of mortality. Regarding apathy as a dimensional construct, one standard deviation increase of AES-10 scores was associated with a 62% increase of mortality risk ( HR = 1.62, 95% CI = 1.40-1.88, P < .001). Conclusions Apathy was associated with mortality over a 4-month period in NH patients, even when controlling for depression. These data suggest that screening and treatment strategies for apathy should be developed for this patient population.
- Subjects
NETHERLANDS; APATHY; MORTALITY; NURSING home patients; DEMENTIA care units; PROGNOSIS; CARE of dementia patients; DEPRESSION in old age; MORTALITY of men; PSYCHOLOGY; HEALTH; MORTALITY risk factors; CONFIDENCE intervals; MEDICAL cooperation; PROBABILITY theory; RESEARCH; PROPORTIONAL hazards models; DESCRIPTIVE statistics
- Publication
Journal of the American Geriatrics Society, 2017, Vol 65, Issue 10, p2182
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1111/jgs.15007