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Low-grade inflammation differentiates between symptoms of apathy and depression in community-dwelling older individuals

Published online by Cambridge University Press:  30 December 2014

Lisa S. M. Eurelings ,
Edo Richard ,
Piet Eikelenboom ,
Willem A. van Gool  and
Eric P. Moll van Charante
Lisa S. M. Eurelings*
Affiliation:
Department of Neurology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
Edo Richard
Affiliation:
Department of Neurology, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, the Netherlands
Piet Eikelenboom
Affiliation:
Department of Neurology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands Department of Psychiatry, VU University Medical Center, De Boelelaan 1117, 1081 HZ, Amsterdam, the Netherlands GGZ inGeest, PO Box 74077, 1070 BB, Amsterdam, the Netherlands
Willem A. van Gool
Affiliation:
Department of Neurology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
Eric P. Moll van Charante
Affiliation:
Department of General Practice, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, the Netherlands
*
Correspondence should be addressed to: Lisa S. M. Eurelings, Academic Medical Center, department of Neurology, room H2-235, PO Box 22660, 1100 DD Amsterdam, the Netherlands. Phone: +31 20 5663446; Fax: +31 20 5669290. Email: l.s.eurelings@amc.nl.
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Abstract

Background:

Systemic low-grade inflammation has repeatedly been associated with depression in old age, but the relationship with apathy is less clear. The present study assessed whether C-reactive protein (CRP) is differentially associated with symptoms of apathy and depression.

Methods:

A population-based cohort study was carried-out. At baseline and after two and four years of follow-up, CRP levels were assessed and symptoms of apathy and depression were measured using the 15-item Geriatric Depression Scale. Logistic regression analysis was used to investigate the cross-sectional and longitudinal associations of CRP with symptoms of apathy and depression.

Results:

Two thousand forty-seven community-dwelling participants (70–78 years) without a history of cardiovascular disease or stroke were studied. A cross-sectional association was found between CRP and apathy symptoms at three time points (odds ratio (OR) per natural log unit increase in CRP: baseline visit = 1.40, 95% CI = 1.12–1.75; two-year follow-up visit = 1.62, 95% CI = 1.17–2.25; four-year follow-up visit = 1.51, 95% CI = 1.03–2.21). This did not change after adjustment for demographics and depressive symptoms, and was slightly attenuated after adjustment for cardiovascular risk factors. No cross-sectional association was found with depressive symptoms. Baseline CRP did not predict incident apathy or depressive symptoms during four years of follow-up.

Conclusions:

Increased CRP levels are associated with apathy symptoms but not with depressive symptoms. This suggests a differential effect of inflammation on apathy and depression. In older persons, symptoms of apathy may be a behavioral manifestation of concurrent low-grade inflammation.

Keywords

apathydepressioninflammationC-reactive proteincardiovascular disease
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 4 , April 2015 , pp. 639 - 647
Copyright
Copyright © International Psychogeriatric Association 2014 

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