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Apathy in acute stroke patients
L Caeiro1, J M Ferro, M L Figueira
1Institute of Molecular Medicine, Faculty of Medicine of the University of Lisbon, Lisbon, Portugal. laracaeiro@fm.ul.pt
European Journal of Neurology
|September 8, 2011
Summary
Apathy is common in acute stroke patients and linked to intracerebral hemorrhage and right-sided brain lesions. This condition was not associated with cognitive impairment or depression but predicted a worse functional outcome.
Area of Science:
- Neurology
- Neuroscience
- Psychiatry
Background:
- Apathy is a frequent complication observed in patients following a stroke.
- Understanding the underlying causes and predictors of apathy in stroke is crucial for patient care.
Purpose of the Study:
- To determine if apathy in stroke patients is secondary to the stroke itself or hospitalization.
- To investigate the relationship between apathy and specific stroke lesion locations (thalamic, striatocapsular).
- To assess if apathy is independent of cognitive impairment and depression in the acute stroke phase and its association with functional outcomes.
Main Methods:
- A case-control study involving 94 acute stroke patients and 50 acute coronary syndrome patients.
- Apathy was measured using the 10-item Apathy Evaluation Scale-Clinical.
- Cognition, depression, and functional outcomes were assessed using the Mini-Mental State Examination (MMSE), Montgomery Åsberg Depression Rating Scale, and modified Rankin Scale, respectively.
Main Results:
- Apathy was present in 38.3% of acute stroke patients and 24% of acute coronary syndrome patients.
- Independent predictors for apathy included cerebral hemorrhage (OR=3.5), low educational level (OR=4.7), and right hemispherical lesions (OR=3.0).
- Apathy was not associated with cognitive impairment or depression but was linked to a worse functional outcome (P=0.03).
Conclusions:
- Apathy is a frequent condition in patients experiencing acute stroke.
- Acute intracerebral hemorrhage and right hemispherical lesions are significant predictors of apathy in stroke patients.
- Apathy in acute stroke is an independent factor associated with poorer functional outcomes at discharge.
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