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. 2013 Apr;21(4):391-7.
doi: 10.1016/j.jagp.2012.12.012. Epub 2013 Feb 6.

Phenotyping apathy in individuals with Alzheimer disease using functional principal component analysis

Jamie M Zeitzer  1 , Renaud David, Leah Friedman, Emmanuel Mulin, René Garcia, Jia Wang, Jerome A Yesavage, Philippe H Robert, William Shannon
Affiliations

Phenotyping apathy in individuals with Alzheimer disease using functional principal component analysis

Jamie M Zeitzer et al. Am J Geriatr Psychiatry. 2013 Apr.

Abstract

Objectives: To determine if there is a specific pattern of gross motor activity associated with apathy in individuals with Alzheimer disease (AD).

Design: Examination of ad libitum 24-hour ambulatory gross motor activity patterns.

Setting: Community-dwelling, outpatient.

Participants: Ninety-two individuals with AD, 35 of whom had apathy.

Measurements: Wrist actigraphy data were collected and examined using functional principal component analysis (fPCA).

Results: Individuals with apathy have a different pattern of gross motor activity than those without apathy (first fPCA component, p <0.0001, t = 5.73, df = 90, t test) such that there is a pronounced decline in early afternoon activity in those with apathy. This change in activity is independent of depression (p = 0.68, F[1, 89] = 0.05, analysis of variance). The decline in activity is consistent with an increase in napping. Those with apathy also have an early wake and bedtime (second fPCA component, t = 2.53, df = 90, p <0.05, t test).

Conclusions: There is a signature activity pattern in individuals with apathy and AD that is distinct from those without apathy and those with depression. Actigraphy may be a useful adjunctive measurement in the clinical diagnosis of apathy in the context of AD.

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Figures

FIGURE 1
FIGURE 1
Average activity curves in individuals with AD and with (blue) or without (red) apathy. Data were averaged at each minute across subjects and are presented ±SEM. The encircled 1 notes the dip in midday activity that appears larger in those with apathy, which is substantiated by the fPCA analysis (fPCA1, see text). The encircled 2 notes an earlier offset in activity in those with apathy, which is substantiated by the fPCA analysis (fPCA2, see text).
FIGURE 2
FIGURE 2
Results of the fPCA analysis. The solid curve in each of the four plots is the same average curve. Adding (+) or subtracting (−) each of the first four components derived from the fPCA analysis are shown separately in the four plots. All subjects are represented in these curves independent of diagnosis of apathy.
FIGURE 3
FIGURE 3
fPCA1 curves for individual subjects with (blue) and without (red) apathy.
FIGURE 4
FIGURE 4
fPCA2 curves for individual subjects with (blue) and without (red) apathy.
See this image and copyright information in PMC

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