Evaluation of the Relationship Between Apathy and UPDRS, H&Y Scores, Levodopa Dose, Prodromal Stage Findings, Disease Stage, and Disease Type in Parkinson’s Disease

Abstract

Objective: This study aimed to investigate the prevalence of apathy in Parkinson’s Disease (PD) and explore its potential clinical correlates. Methods: Ninety-eight patients diagnosed with PD based on MDS clinical criteria and followed at the Movement Disorders Clinic of Sakarya University were included. Apathy was assessed using the Starkstein Apathy Scale. Clinical features including disease stage, motor subtype, prodromal symptoms, and daily total levodopa dosage were evaluated in relation to apathy status. Results: Apathy was detected in 59.2% of the participants. The apathy-positive group had significantly higher UPDRS III and H&Y scores (p<0.05), as well as longer disease duration and higher daily levodopa dosages. Although apathy was more frequent in advanced-stage patients and in the akinetic-rigid subtype, these differences did not reach statistical significance. Constipation and REM sleep behavior disorder were more commonly observed in the apathy group, though again without statistical significance. Conclusion: Apathy is a common and clinically relevant non-motor symptom in PD, particularly associated with greater motor impairment and longer disease duration. Our findings underline the need for increased awareness and further investigation into the pathophysiology and clinical management of apathy in PD.

Keywords

• Parkinson’s disease
• Apathy
• Non-motor symptoms
• Disease duration

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