Journal
PSYCHOLOGICAL MEDICINE
Volume 51, Issue 8, Pages 1338-1344Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291720000094
Keywords
Apathy; cognition; depression; Huntington's disease
Categories
Funding
- CHDI/High Q Foundation Inc
- CHDI
- UCL
- Huntington's Disease Society of America
- MRC [UKDRI-1008/2] Funding Source: UKRI
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The study found that apathy is a predictor of cognitive decline in premanifest HD patients, while motor symptoms severity is a stronger predictor in early diagnosed HD patients. Older age is the only predictor for cognitive decline in healthy control group.
Background Cognitive impairment is a core feature of Huntington's disease (HD), however, the onset and rate of cognitive decline is highly variable. Apathy is the most common neuropsychiatric symptom of HD, and is associated with cognitive impairment. The aim of this study was to investigate apathy as a predictor of subsequent cognitive decline over 2 years in premanifest and early HD, using a prospective, longitudinal design. Methods A total of 118 premanifest HD gene carriers, 111 early HD and 118 healthy control participants from the multi-centre TRACK-HD study were included. Apathy symptoms were assessed at baseline using the apathy severity rating from the Short Problem Behaviours Assessment. A composite of 12 outcome measures from nine cognitive tasks was used to assess cognitive function at baseline and after 24 months. Results In the premanifest group, after controlling for age, depression and motor signs, more apathy symptoms predicted faster cognitive decline over 2 years. In contrast, in the early HD group, more motor signs, but not apathy, predicted faster subsequent cognitive decline. In the control group, only older age predicted cognitive decline. Conclusions Our findings indicate that in premanifest HD, apathy is a harbinger for cognitive decline. In contrast, after motor onset, in early diagnosed HD, motor symptom severity more strongly predicts the rate of cognitive decline.
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