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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Expanding the Model of Apathy in Parkinson's Disease: Exploration of Conceptual Domains and Identification of Neuropsychological Correlates

Myerson, Connie 29 June 2011 (has links)
Apathy is a debilitating non-motor symptom in Parkinson’s disease (PD) that is closely associated with cognitive dysfunction, depression, and caregiver burden. The proposed etiology and operational definition of apathy involves a tripartite model that includes cognitive, behavioral, and emotional manifestations. This theoretical model has not been statistically validated. We examined the tripartite structure of apathy in PD, and subsequent associations between apathy factors and demographic, disease, and neuropsychological measures. One hundred forty-one patients with idiopathic PD underwent neurological examination and comprehensive neuropsychological testing including the Apathy Evaluation Scale (AES). Statistical analyses included correlation, means comparison, item analysis, and confirmatory factor analysis using SEM. The AES was found to be a valid and reliable measure of apathy. Although a tripartite model of apathy was not supported, a novel 3-factor structure of apathy (R-Apathy) emerged characterized by Cognitive/Emotional and Behavioral factors. Both education and depression were significantly associated with R-Apathy. When these were controlled, R-Apathy was associated with impairment in select executive function and visuospatial skills. Apathy remains an important dimension in understanding nonmotor changes in PD. As a whole, apathy correlated with specific areas of neuropsychological dysfunction apart from the influence of depression. Manifestations of apathy such as mental disengagement and behavioral withdrawal are key features of the disease presentation. The importance of evaluating apathy as a contributing factor to patients’ neurocognitive status, mood, and psychosocial functioning should not be underestimated. Furthermore, an apathy evaluation should be included as a standard part of a Parkinson’s evaluation.

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