Pre‐stroke and early post‐stroke apathy is associated with increased risk of dementia 3 months after stroke

Abstract

AbstractObjectivesApathy is a frequent neuropsychiatric syndrome after stroke. We determined whether pre‐morbid and early post‐stroke apathy predicts dementia 3 months after stroke.MethodsWe included ischemic stroke patients without dementia who participated in the Prospective Observational Polish Study on post‐stroke delirium. We used the Neuropsychiatric Inventory and clinician‐reported version of Apathy Evaluation Scale to score apathy symptoms before stroke and on day 8 after stroke. Patients underwent neuropsychological examination 3 months after stroke.ResultsOf 422 patients with ischemic stroke and without pre‐stroke dementia, 194 patients (mean age: 67.5 ± 12.3; 45.9% female) underwent neuropsychological examination. Dementia was diagnosed in 21.6% of them. Patients with dementia had higher apathy scores before stroke (mean: 0.9 ± 1.7 vs. 0.2 ± 0.9, p < 0.01) and on day 8 (mean: 37.2 ± 9.3 vs. 29.0 ± 9.6, p < 0.01). Depressive symptoms did not differ between groups. In multivariate analysis adjusted for age, diabetes mellitus, stroke severity and in‐hospital delirium, apathy symptoms before stroke and on day 8 after stroke predicted post‐stroke dementia (adjusted OR: 1.59, 95%CI: 1.13–2.26, p = 0.01 and OR: 1.06, 95%CI: 1.01–1.11, p = 0.03, respectively).ConclusionsPre‐stroke and early post‐stroke apathy independently from age, stroke severity and delirium predicted dementia 3 months after stroke. Apathy might be useful in identifying at‐risk patients.