Distinct Subtypes of Apathy Revealed by the Apathy Motivation Index

Abstract

Apathy is a debilitating but poorly understood disorder characterized by a reduction in motivation. As well as being associated with several brain disorders, apathy is also prevalent in varying degrees in healthy people. Whilst many tools have been developed to assess levels of apathy in clinical disorders, surprisingly there are no measures of apathy suitable for healthy people. Moreover, although apathy is commonly comorbid with symptoms of depression, anhedonia and fatigue, how and why these symptoms are associated is unclear. Here we developed the Apathy-Motivation Index (AMI), a brief self-report index of apathy and motivation. Using exploratory factor analysis (in a sample of 505 people), and then confirmatory analysis (in a different set of 479 individuals), we identified subtypes of apathy in behavioural, social and emotional domains. Latent profile analyses showed four different profiles of apathy that were associated with varying levels of depression, anhedonia and fatigue. The AMI is a novel and reliable measure of individual differences in apathy and might provide a useful means of probing different mechanisms underlying sub-clinical lack of motivation in otherwise healthy individuals. Moreover, associations between apathy and comorbid states may be reflective of problems in different emotional, social and behavioural domains.

Differential impact of behavioral, social, and emotional apathy on Parkinson's disease

“…Furthermore, according to the AMI cutoff scores derived from Ang et al. (2017),6 36 of all 102 patients with PD were apathetic on at least one subscale (Fig. S1).…”

“…Participants completed the Apathy Motivation Index (AMI),6 which assesses apathy in terms of behavioral activation (BA: tendency to self‐initiate goal‐directed behavior), social motivation (SM: level of engagement in social interactions), and emotional sensitivity (ES: feelings or affective responses), the Lille Apathy Rating Scale (LARS)12 (patients N  =   87), the Snaith–Hamilton Pleasure Scale (SHAPS)14 (patients N  =   84, controls N  =   67), and the Geriatric Depression Scale–Short Form (GDS‐15)15 (patients n  = 80, controls N  =   87).…”

“…Theoretical accounts5 and new evidence6 suggest that rather than being a unitary construct, apathy is multidimensional, involving behavioral, cognitive, executive, social, and emotional domains. Despite the high prevalence of apathy in PD, it is unclear whether all domains are affected 7.…”

“…Here, we used the Apathy Motivation Index (AMI), a new self‐report measure of apathy, rigorously validated in a large sample of healthy people,6 to examine the multidimensional profile of apathy in PD. We also assessed how different apathy domains were related to depression and anhedonia.…”

A survey on the prevalence of apathy in elderly people referred to specialized memory centers

“…9,10 In people with neurodegenerative disorders, apathy can appear at the early stages of the disease progression, and the presence of apathy can be associated to a faster cognitive and functional decline. 14 On the basis of the classical apathy definition, 1,15 Robert et al 16 In the last decade, there have been considerable advances in the domain of apathy, including its biological and neural bases, 17 which led a group of experts to propose a revision of the 2009 DCA. 14 On the basis of the classical apathy definition, 1,15 Robert et al 16 In the last decade, there have been considerable advances in the domain of apathy, including its biological and neural bases, 17 which led a group of experts to propose a revision of the 2009 DCA.…”