Post-stroke apathy: symptom profiles and association with cognitive impairment
Bibliographic record
Abstract
Post-stroke apathy is a debilitating behavioural syndrome affecting cognition, mood and outcome in about 35%-40% stroke survivors. Apathy is known to be associated with cognitive impairment and may be a prodromal symptom of vascular dementia. We aimed to explore apathy profiles in stroke survivors and the association of apathy with cognition one year after stroke. Patients with acute ischaemic stroke underwent assessments at baseline and 1 year after stroke. Where possible, informants were recruited. We assessed apathy with the informant-rated version of the Dimensional Apathy Scale (DAS), cognition with Montreal Cognitive Assessment (MoCA) and Brief Memory and Executive Test (BMET). Latent Class Analysis (LCA) was used to explore the profile of apathy in stroke patients at baseline based on scores on the three DAS dimensions. Linear regression analyses were used to determine whether apathy scores at baseline were associated with cognitive scores at 1 year. Regression analyses were controlled for age, gender, education, disability (modified Rankin Score) and depression (Geriatric Depression Scale) at one year. Out of 200 participants recruited at baseline, 165 were assessed one year later. At baseline 109 informants were also recruited. Mean age of patients at recruitment was 65.8 ± 13.7, and 38.0% of participants were women. LCA showed three distinct subgroups with progressively greater levels of apathy. The larger group (57.8%) had low apathy in every dimension. A second group (23.9%) showed higher apathy on the Emotional-Initiation dimensions. The smaller group (18.3%) had higher apathy sores on every dimension. We found DAS total score associated with lower MoCA score at 12 months (β = -0.14, 95% CI [-0.21, -0.06]), lower BMET total score (β = -0.09, 95% CI [-0.18, -0.00]), and lower BMET processing speed (β = -0.06, 95% CI [-0.11, -0.00]). While about half of our cohort presented generally low apathy, our results suggest that distinct profiles of apathy in stroke exist, with Emotional and Initiation apathy playing a key role. Our study shows that apathy seems to predict worse cognitive functioning one year after stroke, regardless of disability and depressive symptoms.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".