Grant: Travel Awards - Institute Community Support

Apathy is an under diagnosed, yet common, condition in various patient populations with one study showing a prevalence of 23.7% in people over the age of 50. Apathy is characterized by feelings of indifference, a decrease in motivation and initiation. While cognition is known to decline with age, patients with cardiovascular disease are at a higher risk for cognitive impairments. Furthermore, patients with coronary artery disease (CAD) or CAD related disorders (CAD-RD) may suffer from various comorbidities - apathy being one of them. Early detection of apathy is particularly important in CAD patients, as it may affect adherence to secondary prevention interventions such as cardiac rehabilitation (CR). A tool for diagnosing apathy must be integrated into clinical care to detect lack of motivation for improving cardiovascular health. In this study, we devised a short (5-10 minute) screening tool to investigate how apathy affects completion of CR in patients with CAD and CAD-RD. This 5-10 minute screen consists of assessments evaluating memory, executive function, depression, anxiety and apathy. Patients are then enrolled into the second part of the study that will validate results from the screen. Specifically, the apathy evaluation scale will be used as a self-reported measure of apathy as it is one of the most commonly used and validated scales available to date. We hypothesize that at the end of a 6 month CR program at the University Health Network Toronto Rehab-Cardiac clinic , apathy will be inversely associated with completion of CR and it will be associated with less attendance of classes. Once validated, this tool can potentially be placed in hospitals and clinics allowing caregivers to detect clinically important co-morbidities in a short period of time. Identifying apathy as a risk factor for CR completion will help improve cardiovascular outcomes and lower overall economic burdens.