Cambridge Research: Apathy could predict onset of dementia years before other symptoms

University of Cambridge | October 2020 |Apathy could predict onset of dementia years before other symptoms

A team of researchers led by Professor James Rowe at the University of Cambridge have shown how apathy predicts cognitive decline even before the dementia symptoms emerge. 

This longitudinal study followed 304 healthy participants who carry a faulty gene that causes frontotemporal dementia (FTD), and 296 of their relatives who have normal genes. All particpants were assessed at the outset of the study and every two years over several years. None had dementia, and most people in the study did not know whether they carry a faulty gene or not. The researchers looked for changes in apathy, memory tests and MRI scans of the brain, and they found that apathy severity increased over time in presymptomatic carriers, but not in non‐carriers. Among those who carried the gene , baseline gray matter volume of frontal lobe and cingulate cortex predicted the faster progression of apathy over 2 years. (Source: Malpetti, et al, 2020 & University of Cambridge).

“By studying people over time, rather than just taking a snapshot, we revealed how even subtle changes in apathy predicted a change in cognition, but not the other way around,” explained Malpetti, the study’s first author. “We also saw local brain shrinkage in areas that support motivation and initiative, many years before the expected onset of symptoms. The more we discover about the earliest effects of frontotemporal dementia, when people still feel well in themselves, hte better we can treat symptoms and delay or even prevent the dementia.

First author of the study Dr Maura Malpetti

The paper discusses how apathy is an early marker of FTD‐related changes and predicts a subsequent subclinical deterioration of cognition before dementia onset.

Malpetti, M. et al (2020)| Apathy in presymptomatic genetic frontotemporal dementia predicts cognitive decline and is driven by structural brain changes| Alzheimer’s & Dementia |https://doi.org/10.1002/alz.12252

Abstract
Introduction

Apathy adversely affects prognosis and survival of patients with frontotemporal dementia (FTD). We test whether apathy develops in presymptomatic genetic FTD, and is associated with cognitive decline and brain atrophy.

Methods

Presymptomatic carriers of MAPTGRN or C9orf72 mutations (N = 304), and relatives without mutations (N = 296) underwent clinical assessments and MRI at baseline, and annually for 2 years. Longitudinal changes in apathy, cognition, gray matter volumes, and their relationships were analyzed with latent growth curve modeling.

Results

Apathy severity increased over time in presymptomatic carriers, but not in non‐carriers. In presymptomatic carriers, baseline apathy predicted cognitive decline over two years, but not vice versa. Apathy progression was associated with baseline low gray matter volume in frontal and cingulate regions.

Discussion

Apathy is an early marker of FTD‐related changes and predicts a subsequent subclinical deterioration of cognition before dementia onset. Apathy may be a modifiable factor in those at risk of FTD.

Primary paper is published in the journal Alzheimer’s & Dementia

University of Cambridge Apathy could predict onset of dementia years before other symptoms

Apathy in presymptomatic genetic frontotemporal dementia predicts cognitive decline and is driven by structural brain changes

In the news:

Science Daily Apathy could predict onset of dementia years before other symptoms

The Daily Mail Apathy and lack of motivation in your mid-forties could be an early warning sign of dementia, study suggests

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