Background

Diagnostic criteria for apathy have been published but have yet to be evaluated in the context of clinical trials. The Apathy in Dementia Methylphenidate Trial 2 (ADMET 2) operationalized the diagnostic criteria for apathy (DCA) into a clinician-rated questionnaire informed by interviews with the patient and caregiver.

Objective

The goal of the present study was to compare the classification of apathy using the DCA with that using the Neuropsychiatric Inventory-apathy (NPI-apathy) subscale in ADMET 2. Comparisons between NPI-Apathy and Dementia Apathy Interview Rating (DAIR) scale, and DCA and DAIR were also explored.

Methods

ADMET 2 is a randomized, double-blind, placebo-controlled phase III trial examining the effects of 20 mg/day methylphenidate on symptoms of apathy over 6 months in patients with mild to moderate Alzheimer's disease (AD). Participants scoring at least 4 on the NPI-Apathy were recruited. This analysis focuses on cross-sectional correlations between baseline apathy scale scores using cross-tabulation.

Results

Of 180 participants, the median age was 76.5 years and they were predominantly white (92.8%) and male (66.1%). The mean (±standard deviation) scores were 7.7 ± 2.4 on the NPI-apathy, and 1.9 ± 0.5 on the DAIR. Of those with NPI-defined apathy, 169 (93.9%, 95% confidence interval [CI] 89.3%–96.9%) met DCA diagnostic criteria. The DCA and DAIR overlapped on apathy diagnosis for 169 participants (93.9%, 95% CI 89.3%–96.9%).

Conclusion

The measurements used for the assessment of apathy in patients with AD had a high degree of overlap with the DCA. The NPI-apathy cut-off used to determine apathy in ADMET 2 selects those likely to meet DCA criteria.

中文翻译：

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在痴呆症冷漠试验 2 (ADMET 2) 中测量阿尔茨海默病的冷漠：仪器比较。

背景

冷漠的诊断标准已经公布，但尚未在临床试验的背景下进行评估。哌醋甲酯痴呆症中的冷漠试验 2 (ADMET 2) 将冷漠的诊断标准 (DCA) 实施为临床医生评定的问卷，该问卷通过与患者和护理人员的面谈获得。

客观的

本研究的目的是比较在 ADMET 2 中使用 DCA 对冷漠分类与使用神经精神库存冷漠 (NPI-冷漠) 子量表的分类。 NPI-冷漠与痴呆冷漠访谈评分 (DAIR) 量表之间的比较，以及还探索了 DCA 和 DAIR。

方法

ADMET 2 是一项随机、双盲、安慰剂对照的 III 期试验，检查 20 毫克/天哌醋甲酯对轻度至中度阿尔茨海默病 (AD) 患者 6 个月内冷漠症状的影响。招募了在 NPI-Apathy 上得分至少 4 分的参与者。该分析侧重于使用交叉表的基线冷漠量表分数之间的横截面相关性。

结果

在 180 名参与者中，中位年龄为 76.5 岁，主要是白人（92.8%）和男性（66.1%）。NPI冷漠的平均（±标准差）得分为7.7±2.4，DAIR为1.9±0.5。在 NPI 定义的冷漠患者中，169 人（93.9%，95% 置信区间 [CI] 89.3%–96.9%）符合 DCA 诊断标准。DCA 和 DAIR 在 169 名参与者的冷漠诊断上重叠（93.9%，95% CI 89.3%–96.9%）。

结论

用于评估 AD 患者冷漠的测量与 DCA 有高度的重叠。用于确定 ADMET 2 中冷漠的 NPI 冷漠截止值选择那些可能符合 DCA 标准的人。