Apathy is an independent risk factor for incident cardiovascular disease in the older individual: a population-based cohort study
Article first published online: 18 SEP 2013
Copyright © 2013 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Volume 29, Issue 5, pages 454–463, May 2014
How to Cite
Eurelings, L. S. M., Ligthart, S. A., van Dalen, J. W., Moll van Charante, E. P., van Gool, W. A. and Richard, E. (2014), Apathy is an independent risk factor for incident cardiovascular disease in the older individual: a population-based cohort study. Int. J. Geriat. Psychiatry, 29: 454–463. doi: 10.1002/gps.4026
- Issue published online: 7 APR 2014
- Article first published online: 18 SEP 2013
- Manuscript Accepted: 27 AUG 2013
- Manuscript Revised: 12 AUG 2013
- Manuscript Received: 13 APR 2013
- cardiovascular disease;
Although depression is considered to be associated with cardiovascular disease (CVD), specifically symptoms of apathy have been strongly associated with a history of CVD in recent studies. In this study, we prospectively assess whether symptoms of apathy and depression are independent risk factors for incident CVD and stroke.
We carried out a prospective cohort study of 1810 community-dwelling older individuals (70–78 years) without a history of CVD or stroke. Symptoms of apathy and depression were assessed with the 15-item Geriatric Depression Scale. Incident CVD and stroke were assessed after 2 years follow-up. The associations of symptoms of apathy and depression with incident CVD and stroke were analyzed separately using logistic regression analysis.
Symptoms of apathy and depression were present in 281 (15.5%) and 266 (14.7%) participants, respectively. Incident CVD occurred in 62 (3.5%) participants and stroke in 55 (3.1%) participants. Apathy was associated with incident CVD after adjustment for demographics and cardiovascular risk factors (odds ratio (OR) = 2.60, 95% CI = 1.46–4.65). Exclusion of subjects with depressive symptoms yielded a similar OR (2.94, 95% CI = 1.45–5.96, n = 1544). No association was found between depressive symptoms and incident CVD. Neither apathy symptoms nor depressive symptoms were associated with incident stroke.
Apathy, but not depression, is a strong, independent risk factor for incident CVD. It may be a marker of underlying vascular disease. By its nature, apathy may cause non-adherence to a healthy lifestyle, diminished activities, and possibly even withdrawal from clinical care aimed at improving vascular risk profiles. Copyright © 2013 John Wiley & Sons, Ltd.