Influencing Factors and Correlation Analysis of Apathy in Patients with Parkinson's Disease

Background: Parkinson's disease (PD) is a complex progressive neurodegenerative disease. The prevalence of Parkinson's disease has increased rapidly in the last 20 years. Apathy, one of the non-motor symptoms of Parkinson's disease, severely affects patients' daily functioning and quality of life, increases the burden on caregivers, and maybe a precursor to dementia. Identifying the factors associated with indifferent PD patients is essential in slowing disease progression and improving patient prognosis. Methods: A total of 73 PD patients from the outpatient or inpatient department of Neurology at the Third Affiliated Hospital of Xinxiang Medical University were collected. The clinical scales of PD patients were assessed. According to Starkstein Apathy Scale (AS), these patients were divided into an apathetic group (46 patients) and a non-apathetic group (27 patients). Spearman correlation analysis and Stepwise multiple linear regression analysis were used to explore the correlation between total AS scores and clinical characteristics. Results: Spearman correlation analysis showed that the total scores of AS were positively correlated with disease duration, HY stages, Movement Disorders Society Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) scores, Hamilton Anxiety Rating Scale (HAMA) scores, Hamilton Depression Rating Scale (HAMD) scores, Pittsburgh Sleep Quality Index (PSQI) scores, King's Parkinson's Disease Pain Scale ( KPPS) scores, Parkinson Autonomic Symptom Scale (SCOPA-AUT) scores, and 39-item Parkinson's Disease Questionnaire (PDQ-39) scores. It was negatively correlated with Montreal Cognitive Assessment (MoCA) scores and Mini-Mental Status Examination (MMSE) scores. Stepwise multiple linear regression analysis showed that low MoCA scores and high HAMA scores were correlated with apathy, indicating that MoCA scores and HAMA scores may be important determinants of apathy in PD patients. Conclusion: PD patients with apathy showed longer disease duration, higher Hoehn and Yahr (HY) stages, more severe motor dysfunction, more severe cognitive impairment, more severe anxiety, more depression symptoms, more severe sleep symptoms, more severe autonomic dysfunction and worse quality of life. Cognitive dysfunction and anxiety may be the risk factors for PD patients with apathy.