ABSTRACT

Apathy is common after stroke and has been associated with cognitive impairment. However, causality between post-stroke apathy and cognitive impairment remains unclear. We assessed the course of apathy in relation to changes in cognitive functioning in stroke survivors. Using the Apathy Scale (AS) and cognitive tests on memory, processing speed and executive functioning at six- and 15 months post-stroke we tested for associations between (1) AS-scores and (change in) cognitive scores; (2) apathy course (persistent/incident/resolved) and cognitive change scores. Of 117 included participants, 29% had persistent apathy, 13% apathy resolving over time and 10% apathy emerging between 6-15 months post-stroke. Higher AS-scores were cross-sectionally and longitudinally associated with lower cognitive scores. Relations between apathy and cognitive change scores were ambiguous. These inconsistent relations between apathy and changes in cognition over time suggest that post-stroke apathy does not directly impact cognitive performance. Both these sequelae of stroke require separate attention.

摘要

冷漠在中风后很常见，并且与认知障碍有关。然而，卒中后冷漠与认知障碍之间的因果关系仍不清楚。我们评估了与中风幸存者认知功能变化相关的冷漠过程。在中风后 6 个月和 15 个月，使用冷漠量表 (AS) 和记忆力、处理速度和执行功能的认知测试，我们测试了 (1) AS 分数和（变化）认知分数之间的关联；(2)冷漠过程(持续/事件/解决)和认知变化得分。在 117 名参与者中，29% 的人有持续的冷漠，13% 的冷漠随着时间的推移而消退，10% 的冷漠在中风后 6-15 个月之间出现。较高的 AS 分数在横截面和纵向上与较低的认知分数相关。冷漠和认知改变分数之间的关系是模棱两可的。随着时间的推移，冷漠与认知变化之间的这些不一致关系表明，中风后冷漠不会直接影响认知表现。这两种中风后遗症都需要分别注意。