The course of apathy in late-life depression treated with electroconvulsive therapy; a prospective cohort study

A. Carlier*, E. van Exel, A. Dols, F. Bouckaert, P. Sienaert, M. ten Kate, M. P. Wattjes, M. Vandenbulcke, M. L. Stek, D. Rhebergen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objectives: Apathy, a lack of motivation, is frequently seen in older individuals, with and without depression, with substantial impact on quality of life. This prospective cohort study of patients with severe late-life depression treated with electroconvulsive therapy (ECT) aims to study the course of apathy and the predictive value of vascular burden and in particular white matter hyperintensities on apathy course. Methods: Information on apathy (defined by a score of >13 on the Apathy Scale), depression severity, vascular burden, and other putative confounders was collected in at 2 psychiatric hospitals on patients with late-life depression (aged 55 to 87 years, N = 73). MRI data on white matter hyperintensities were available in 52 patients. Possible risk factors for apathy post-ECT were determined using regression analyses. Results: After treatment with ECT, 52.0% (26/50) of the depression remitters still suffered from clinically relevant apathy symptoms. In the entire cohort, more patients remained apathetic (58.9%) than depressed (31.5%). Presence of apathy post-ECT was not associated with higher age, use of benzodiazepines, or severity of apathy and depression at baseline. Less response in depressive symptomatology after ECT predicted post-treatment apathy. The presence of vascular disease, diabetes mellitus and smoking, and white matter hyperintensities in the brain was not associated with post-treatment apathy. Conclusions: Apathy may perpetuate in individual patients, despite remission of depressive symptoms. In this cohort of patients with late-life depression, post-ECT apathy is not associated with white matter hyperintensities.

Original languageEnglish
Pages (from-to)1253-1259
Number of pages7
JournalInternational Journal of Geriatric Psychiatry
Issue number9
Early online date30 May 2018
Publication statusPublished - 1 Sep 2018

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