Objective: To evaluate the association between baseline apathy and probable incident dementia in a population-based sample of community-dwelling older adults.

Methods: We studied 2,018 white and black community-dwelling older adults from the Health, Aging, and Body Composition (Health ABC) study. We measured apathy at year 6 (our study baseline) with the modified Apathy Evaluation Scale and divided participants into tertiles based on low, moderate, or severe apathy symptoms. Incident dementia was ascertained over 9 years by dementia medication use, hospital records, or clinically relevant cognitive decline on global cognition. We examined the association between apathy and probable incident dementia using a Cox proportional hazards model adjusting for demographics, cardiovascular risk factors, APOE-4 status, and depressed mood. We also evaluated the association between the apathy group and cognitive change (as measured by the Modified Mini Mental State Examination and Digit Symbol Substitution Test over 5 years) using linear mixed effects models.

Results: Over 9 years of follow-up, 381 participants developed probable dementia. Severe apathy was associated with an increased risk of dementia compared to low apathy (25% vs 14%) in unadjusted (HR 1.9, 95% CI 1.5–2.5) and adjusted models (HR 1.7, 95% CI 1.3–2.2). Greater apathy was associated with worse cognitive score at baseline, but not rate of change over time.

Conclusion: In a diverse cohort of community-dwelling adults, apathy was associated with increased risk of developing probable dementia. This study provides novel evidence for apathy as a prodrome of dementia.

These data was collected through the Health ABC study and cleaned and analyzed in Stata. There are no direct identifiers in the dataset. To avoid having >3 indirect identifiers, I removed age and gender from the dataset. 

Please see below for the data dictionary, with age and gender removed

habcid          double  %11.0g                HABC ENROLLMENT ID
apoehap         double  %12.0g                Apo E genotyping (e2, e3, e4)
dep             double  %12.0g                YR1:AT RISK FOR DEPRESSION (CES-D GE 16)
ces_d           double  %5.0g                 CES-D
stroke          double  %12.0g                Year 1 current cereb dx: stroke, tia, cend
htn             double  %12.0g                Year 1 current hypertension
apoe4           double  %12.0g                APOE e4 carrier
white           double  %12.0g                Race
eduhs           double  %12.0g                Education
mi              double  %12.0g                 History of myocardial infarction
dm              double  %12.0g                History of DM
obese           double  %12.0g               History of obesity
fbaaf01         double  %12.0g                Apathy question: Y6Q69:4 wks�how interested in activities
fbaaf02         double  %12.0g                Apathy question: Y6Q70:4 wks�how interested leaving home?
fbaaf03         double  %12.0g                Apathy question: Y6Q71: 4 wks�how interested w,friends?
fbaaf04         double  %12.0g                Apathy question: Y6Q72:  Getting thgs done�is important
fbaaf05         double  %12.0g                Apathy question: Y6Q73: Seeing a job�to the end�important
dem_dx          double  %12.0g               Dementia diagnosis
dementia        double  %12.0g               Dementia diagnosis
dep_y6          double  %12.0g                Depression at year 6
event_date      long    %d                       Date of dementia diagnosis
time_to_event   double  %5.0g               Time to dementia diagnosis
missy6          double  %12.0g                0=had year 6 visit date, 1=no year 6 visit date
dem_after_y6    double  %12.0g                0=dementia before year 6; 1=dementia after year 6
dod             long    %d                    Date*of*Death