Leiden University Student Repository

Moret, Katja (2025)

Longitudinal Associations Between Structural and Dynamic Vascular Factors and Apathy Symptoms in Older Persons - The DANTE Study Leiden

Master thesis | Psychology (MSc)

Background: the vascular hypothesis of apathy suggests a link between vascular factors like cerebral small vessel disease (CSVD) and apathy symptoms, through lesions in the brain’s reward network. Previous studies found a cross-sectional association between lower blood pressure (BP) and symptoms of apathy in older persons with more CSVD, potentially through reduced cerebral blood flow (CBF). However, longitudinal research on these associations is lacking. This thesis investigated whether structural and dynamic vascular factors are associated with apathy symptoms over time in older persons. Methods: this longitudinal cohort study used participants of the Discontinuation of ANtihypertensive Treatment in the Elderly (DANTE)-Leiden, community-dwelling older persons on antihypertensive treatment with mild cognitive deficits. BP was measured at baseline and apathy was assessed with the Apathy Scale at baseline and after four years of follow-up (n=178). Additionally, a baseline MRI sub...Show moreBackground: the vascular hypothesis of apathy suggests a link between vascular factors like cerebral small vessel disease (CSVD) and apathy symptoms, through lesions in the brain’s reward network. Previous studies found a cross-sectional association between lower blood pressure (BP) and symptoms of apathy in older persons with more CSVD, potentially through reduced cerebral blood flow (CBF). However, longitudinal research on these associations is lacking. This thesis investigated whether structural and dynamic vascular factors are associated with apathy symptoms over time in older persons. Methods: this longitudinal cohort study used participants of the Discontinuation of ANtihypertensive Treatment in the Elderly (DANTE)-Leiden, community-dwelling older persons on antihypertensive treatment with mild cognitive deficits. BP was measured at baseline and apathy was assessed with the Apathy Scale at baseline and after four years of follow-up (n=178). Additionally, a baseline MRI sub-study (n=109) was conducted to measure CSVD and CBF. Results: the mean age of the sample was 80 years (SD 4) and 63% was female. No significant association was found between the summary CSVD scores (β(95% CI)=0.018(-1.089-1.125), p=.975) or its separate features; WMH (β(95%CI)=0.012(-0.011-0.035), p=.318), CMB (β(95%CI)=-0.017(-0.605-0.572), p=.956), lacunar infarctions (β(95% CI)=-0.413(-1.266-0.440), p=.339), and a change in Apathy Scale score. Additionally, no significant association was found between the dynamic vascular factors; CBF (β(95% CI)=-0.029(-0.152-0.094), p=.640), systolic BP (β(95% CI)=-0.019(-0.056-0.018), p=.310) and diastolic BP (β(95%CI) =-0.029(-0.099-0.042), p=.425), and change in Apathy Scale score. The multiple linear regression model, incorporating all the structural and dynamic vascular parameters, was not significant (F(7,90)=1.32 , p=.250, R2=.093). Conclusions: in older persons with mild cognitive deficits, structural and dynamic vascular factors were not associated with apathy symptoms over time, in contrast to previous cross-sectional studies. Our findings did not support the vascular apathy hypothesis. Other factors, such as lifestyle, might confound the cross-sectional association between vascular factors and apathy. This study highlights the importance of further research into vascular factors and apathy, which acknowledge our limitations, or into other possible mechanisms for apathy.Show less

Author

Moret, Katja

Faculty

Faculty of Social & Behavioural Sciences

Specialisation

Clincial Neuropsychology

Supervisors

Wolters, F
Bertens, A.S.

ECTS Credits

20

Language

en