Effect of non-pharmacological intervention for apathy: response to one-on-one reminiscence-based intervention

Abstract

Apathy has adverse consequences for patients and caregivers. However, the therapeutic approach remains uncertain. Here, we present the case of a man aged 67 years who only developed apathy after surgery for oesophageal cancer. He showed no response to intervention with donepezil, a 'brain training' video game and psychoeducation for apathy. Subsequently, we implemented a programme designed to facilitate recall of 2 themes (editorial content and television shows during the week) once a week. After 3 months, the scores of 2 apathy scales rated by the patient's wife, psychological test scores and brain perfusion single-photon emission CT data improved compared with those obtained before intervention. These results may be attributable to activated 2-way communication as well as benefits of reminiscence therapy, as seen in patients with dementia. Further studies are needed to develop additional non-pharmacological interventions that activate 2-way communication for apathetic patients in ways appropriate to their interests and comorbidities.

Improvement in apathy and depression by non‐pharmacological interventions in early‐onset Alzheimer's disease: A longitudinal single‐photon emission computed tomography study

“…6 In contrast, non-pharmacologic intervention reportedly improves CBF in the frontal lobe and improves apathy in older patients without dementia. 7 In the present patient with AD, the CBF in the frontal lobe decreased, despite his markedly improved apathy and depression with non-pharmacological interventions. Additionally, amyloid deposits in the frontal lobe, which are believed to exacerbate apathy, were increased on the amyloid positron emission tomography images.…”