A data-driven examination of apathy and depressive symptoms in dementia with independent replication.
A data-driven examination of apathy and depressive symptoms in dementia with independent replication.
复制标题
独立复制的痴呆症中的冷漠和抑郁症状的数据驱动研究。
DOI：
10.1002/dad2.12398
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发表时间：
2023-01
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冷漠是最常见的神经精神症状之一，与不良的临床结局相关。帮助确定冷漠表型的研究是迫切需要的，特别是对于临床和生物标志物研究。我们使用两个独立队列的潜在类别分析（LCA）来了解冷漠和抑郁症状如何在统计学上共同发生。我们进一步探讨了潜在的阶级成员，人口统计学和其他种族的存在之间的关系。LCA确定了四类解决方案（无症状、冷漠、抑郁和冷漠/抑郁组合），在两个队列中均可重现，为冷漠综合征提供了与抑郁不同的强有力支持，并证实存在冷漠/抑郁综合征，得到模型拟合检验的支持，四类解决方案评分证明拟合更好（贝叶斯信息标准调整和熵R 2）。使用数据驱动的方法，我们显示了冷漠和抑郁症状的独特和统计学意义的共同发生。有证据表明，这些类别具有不同的临床关联，这可能有助于为研究和临床实践提供诊断类别。我们发现了四类：无症状，冷漠，抑郁和冷漠/抑郁。冷漠赋予了更高的可能性激动。冷漠的诊断标准应包括伴随的神经精神症状。
Apathy is one of the most common neuropsychiatric symptoms (NPS) and is associated with poor clinical outcomes. Research that helps define the apathy phenotype is urgently needed, particularly for clinical and biomarker studies. We used latent class analysis (LCA) with two independent cohorts to understand how apathy and depression symptoms co‐occur statistically. We further explored the relationship between latent class membership, demographics, and the presence of other NPS. The LCA identified a four‐class solution (no symptoms, apathy, depression, and combined apathy/depression), reproducible over both cohorts, providing robust support for an apathy syndrome distinct from depression and confirming that an apathy/depression syndrome exists, supported by the model fit test with the four‐class solution scores evidencing better fitting (Bayesian information criterion adjusted and entropy R 2). Using a data‐driven method, we show distinct and statistically meaningful co‐occurrence of apathy and depressive symptoms. There was evidence that these classes have different clinical associations, which may help inform diagnostic categories for research studies and clinical practice. We found four classes: no symptoms, apathy, depression and apathy/depression. Apathy conferred a higher probability for agitation. Apathy diagnostic criteria should include accompanying neuropsychiatric symptoms.