Objective: To determine the frequency and clinical correlates of apathy in Parkinson’s disease (PD) psychosis.

Background: The underlying pathology of apathy in PD psychosis, itself associated with reduced quality of life [1], is poorly understood, and represents an unmet need.

Method: We analysed data from an ongoing single-centre cross-sectional psychometric scale development study in PD (Psy-PD; IRAS ID 229095), where 34 patients with PD psychosis (comprising of minor hallucinations, major hallucinations, and delusions) were assessed with the Starkstein’s Apathy Scale (AS), the Non-Motor Symptom (NMSS), Hospital Anxiety and Depression (HADS), Epworth Sleepiness (ESS), Montreal Cognitive Assessment (MoCA), Hoehn and Yahr, the Unified PD Rating (Motor Section; UPDRS III), and the PD Quality of life (PDQ-8) scales. These AS outcome measures were correlated with other clinical characteristics, using Spearman rank correlations.

Results: Overall, 58.5% of patients had apathy (AS score of ≥ 14), overlapping considerably with depression as expected; 38.2% had apathy alone. AS score was significantly associated with the total NMSS, HADS (depression and anxiety), ESS and PDQ8 scores, even after correction for multiple testing (p≤0.008). None of the following was associated with AS apathy: current age, age at PD diagnosis, Hoehn and Yahr, disease duration, use of selective serotonin reuptake inhibitors (SSRIs), or the MoCA score.

Conclusion: Our findings suggest that apathy may have a significant influence on quality of life and other clinical characteristics in PD patients with psychosis; more severe apathy appeared to be associated with high non-motor symptom burden, excessive daytime sleepiness, high anxiety and depression level, along with reduced quality of life.

References: Holroyd S, Currie L, Wooten GF. Prospective study of hallucinations and delusions in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2001;70(6):734-738.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/apathy-clinical-correlates-in-parkinsons-disease-psychosis/