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Current Gerontology and Geriatrics Research
Volume 2012 (2012), Article ID 390701, 10 pages
http://dx.doi.org/10.1155/2012/390701
Research Article

An Exploration of Apathy and Impulsivity in Parkinson Disease

1Department of Elderly Medicine, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK
2Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK
3Department of Psychiatry and Behavioural Sciences, School of Community-Based Medicine, University of Manchester, Jean McFarlane Building, University Place, Oxford Road, Manchester M13 9PL, UK
4The Research Support and Governance Office, Bradford Institute for Health Research, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ, UK
5Manchester Mental Health and Social Care Trust, Park House, North Manchester General Hospital, Delaunays Road, Manchester M8 5RB, UK

Received 16 February 2012; Revised 12 April 2012; Accepted 14 April 2012

Academic Editor: Philippe H. Robert

Copyright © 2012 David J. Ahearn et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Apathy and impulsivity in Parkinson disease (PD) are associated with clinically significant behavioral disorders. Aim. To explore the phenomenology, distribution, and clinical correlates of these two behaviors. Methods. In PD participants (n=99) without dementia we explored the distribution of measures of motivation and impulsivity using univariate methods. We then undertook factor analysis to define specific underlying dimensions of apathy and impulsivity. Regression models were developed to determine the associated demographic and clinical features of the derived dimensions. Results. The factor analysis of apathy (AES-C) revealed a two-factor solution: “cognitive-behavior” and “social indifference”. The factor analysis of impulsivity (BIS-11) revealed a five-factor solution: “inattention”; “impetuosity”; “personal security”; “planning”; and “future orientation”. Apathy was significantly associated with: age, age of motor symptom onset (positive correlation), disease stage, motor symptom severity, and depression. Impulsivity was significantly associated with: age of motor symptom onset (negative correlation), gambling and anxiety scores, and motor complications. We observed an overlap of apathy and impulsivity in some participants. Conclusion. In PD, apathy and impulsivity have specific phenomenological profiles and are associated with particular clinical phenotypes. In spite of this, there is some overlap of behaviors which may suggests common aspects in the pathology underlying motivation and reward processes.