Apathy in Late Life Depression: New Biomarkers Using Actimetry and Magnetic Resonance Imaging

Summary

Old age (\> 60 years) is at high risk to develop major depression disorders (MDD). MDD doubles the risk for subsequent cognitive disorders and dementia. Apathy (i.e. the lack of motivation) is a core problem in depression in older age and is frequently associated with cognitive decline in people who have mild cognitive disorders. The investigator propose here to combine actimetry (the measurement of motor activity using a simple device worn at the wrist) and brain imaging to show that it's possible to measure apathy using actimetry in a population of elders with MDD. Having shown that apathy can reliably be measured with actimetry and that it is associated with brain abnormalities, the investigator will be able to test whether actimetry can predict cognitive decline in elders with MDD and can be routinely used in a day-to-day medical practice.

Conditions

• Depression

Interventions

OTHER

Mattis Dementia Rating Scale

This scale was developed to assess the cognitive status of patients with neurodegenerative diseases. There are 37 items that are presented in a fixed order and grouped into five sub-scales: attention, initiation, construction, conceptualization and memory. Patients and healthy subjects with a score below 125 are not included because of major cognitive impairment.

OTHER

Unified Parkinson 's Disease Rating Scale-III

This scale is used to rate the severity of extra-pyramidal symptoms (akinesia, rigidity and tremors). These symptoms may be the cause of reduction of motor activity apart from any reduction in motivation, they onstitute a confounding factor that it should be controlled.

OTHER

Mini Neuropsychiatric Investigation

This is a structured interview that allows rapid screening in about 20 minutes of troubles Psychiatric. It is based on short questions to which the patient must answer yes or no and on a decision tree. Patients must validate clinical diagnoses of depression.

OTHER

Montgomery and Asberg depression Rating Scale

This scale is composed of 10 items from 0 to 6 from a semi-structured interview, to obtain a total depression score of 0 to 60 (0 no depression, 60 maximum intensity of depression).

OTHER

Clinical Global Impression

heterosexual assessment that rates the severity of symptoms suicidal and changes in suicidal symptoms. Any subject with a score greater than 4 is not included.

OTHER

Apathy diagnostic criteria

The clinical criteria make it possible to make a diagnosis of apathy with a functional repercussion. It is based on a lack of motivation felt by the patient, causing a functional or social impact that is not the consequence of a disturbance of consciousness or a disability engine. The cognitive, emotional and behavioral dimensions are affected.

OTHER

walking speed test

The patient is timed to walk 10m. A speed \<1m / sec is a criterion exclusion because it shows severe sarcopenia and constitutes a bias.

OTHER

accelerometer presentation

accelerometer presentation and pose

OTHER

data acquisition from the accelerometer

withdrawal of the accelerometer and data acquisition from the accelerometer

OTHER

Apathy Evaluation Scale,

clinician version and near-helping version. It's a hetero rating scale from an interview semi structured by a trained clinician. It assesses cognitive, emotional and behavioral apathy than three items of various apathy. The total score ranges from 18 (total absence of apathy) to 72.

OTHER

fatigue Visual Analog Scale

To date, there is no valid fatigue scale in the depression of the elderly subject, a fortiori in French. The fatigue scale in adult depression includes has been validated with an EVA (Visual Analogue Scale) (38). We therefore propose to use this type of evaluation to control this aspect.

OTHER

executive function

* Modified Card Sorting Test MCST(Modified Card Sorting Test) (Wisconsin Test): This test assesses conceptualization, attention and mental flexibility using a deck of cards. * Trail Making Test (TMT): This test is used to assess mental flexibility. * Fluences verbal: This test tests the capacities of setting up search strategies in memory semantics and oral language. * Stroop Paradigm: This test is used to evaluate the resistance to interference, ie the patient's ability to inhibit some over-learned and automated responses.

OTHER

MRI

An MRI lasting 30 minutes is programmed

OTHER

Apathy Motivation Index

This is a self-questionnaire of 18 items, each side on a 5-level Likert scale (0: not everything at 4: very often). It differentiates between "behavioral" apathy and "social" apathy. "Emotional".

Sponsors & Collaborators

• Rennes University Hospital

  lead OTHER

Study Design

Allocation

NON_RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

60 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2019-08-09

Primary Completion

2023-02-09

Completion

2023-02-09

Countries

• France

Study Locations