Pharmacological and Nonpharmacological Treatment for Apathy in Alzheimer Disease

Theleritis, Christos; Siarkos, Kostas; Katirtzoglou, Everina; Politis, Antonios

doi:10.1177/0891988716678684

Cited by 52 publications

(35 citation statements)

References 163 publications

(225 reference statements)

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“…Two systematic reviews of systematic reviews (Abraha et al, 2017;Vilela, Pacheco, Latorraca, Pachito, & Riera, 2017) reveal that non-pharmacological interventions have positive effects on reducing BPSD, improving cognitive function, activities of daily living, and social interaction ability of patients with dementia. For apathy, there are several systematic reviews and meta-analyses (Brodaty & Burns, 2012;Fukushima et al, 2016;Goris, Ansel, & Schutte, 2016;Lane-Brown & Tate, 2009;Theleritis, Siarkos, Katirtzoglou, & Politis, 2016;Theleritis, Siarkos, Politis, Katirtzoglou, & Politis, 2018;Tsoi et al, 2018;Verkaik, Weert, & Francke, 2005;Zafra-Tanaka, Pacheco-Barrios, Tellez, & Taype-Rondan, 2019) of non-pharmacological interventions in patients with dementia. Nevertheless, these reviews involve diversified non-pharmacological interventions and lack evaluation of methodological quality and classification of evidence quality.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Non‐Pharmacological Interventions on Apathy in Patients With Dementia: A Systematic Review of Systematic Reviews

Cai

et al. 2020

Worldviews Ev Based Nurs

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Background Apathy is one of the behavioral and psychological symptoms of dementia (BPSD), which is the most frequent and can accelerate the progress of dementia. Aims To systematically review the evidence of effectiveness of non‐pharmacological interventions on apathy in patients with dementia. Methods Databases including the Cochrane Library, Joanna Briggs Institute (JBI) Library, PubMed, EMBASE, CINAHL, PsycINFO, Psychology and Behavioral Sciences Collection, CNKI, and Wan Fang Data were searched for systematic reviews of the effectiveness of non‐pharmacological interventions on apathy in patients with dementia. AMSTAR 2 was applied to assess the methodological quality of reviews. Results Nine systematic reviews were included. The average level of overall confidence for included systematic reviews was low. Among all the non‐pharmacological interventions involved in this review, the effectiveness of multisensory stimulation, music therapy, cognitive stimulation, and pet therapy was relatively robust. The effects of reminiscence therapy, therapeutic conversation, progressive muscle relaxation, art therapy, exercise therapy, occupational therapy, dementia special care units, nursing staff education, and comprehensive interventions need to be validated further. Meanwhile, the current evidence failed to support the effects of psychomotor therapy and validation therapy on apathy. Linking Evidence to Action Non‐pharmacological interventions for apathy in patients with dementia are acceptable. In spite of requirements for adequate and high‐quality original studies and quantitative systematic reviews to validate the efficacy of non‐pharmacological interventions, multisensory stimulation, music therapy, cognitive stimulation, and pet therapy are deemed the most helpful according to evidences available.

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Section: Introductionmentioning

confidence: 99%

The Effectiveness of Non‐Pharmacological Interventions on Apathy in Patients With Dementia: A Systematic Review of Systematic Reviews

Cai

et al. 2020

Worldviews Ev Based Nurs

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“…One recent article from January 2017 reviewed recent pharmacological and non-pharmacological approaches for the management of apathy in AD (Theleritis et al, 2017) and reported the potential interest of cholinesterase inhibitors (ChEIs), methylphenidate and gingko biloba in reducing levels of apathy, whereas Sepehry et al's review did not reveal any significant treatment effect likely to reduce apathy in AD (Sepehry et al, 2017). In Theleritis, among 6 studies using galantamine (4 RCT and 2 open-label studies), five studies did show an improvement of apathy levels after treatment.…”

Section: Reviews and Meta-analysesmentioning

confidence: 99%

Pharmacologic Approaches for the Management of Apathy in Neurodegenerative Disorders

et al. 2020

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Apathy is one of the most frequent behavioral disturbances in many neurodegenerative disorders and is known to have a negative impact on the disease progression, particularly in Alzheimer's disease. Therapeutic options are currently limited and non-pharmacological approaches should constitute first line treatments. Pharmacological agents likely to reduce apathy levels are lacking. The objective of the present article is to review recent pharmacological treatments for apathy in neurodegenerative disorders. The Pubmed database was searched with a particular focus on articles published as of January 2017. Current main levels of evidence have been reported so far with cholinergic, glutamatergic and dopaminergic agents to reduce levels of apathy, despite several conflicting results. Treatment duration and samples sizes may have however decreased the validity of previous results. Ongoing studies involving more participants/treatment duration or distinct neural pathways may provide new insights in the treatment of apathy in neurodegenerative disorders.

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“…Even when apathy is recognized, clinicians and families face the additional challenge of identifying adequate treatments. Both pharmacological and nonpharmacological interventions currently lack the prevision needed to target specific apathy subtypes and their underlying mechanisms; nor do they take into account common comorbidities, such as depression, that frequently complicate the management of BPSDs …”

Section: Further Considerations For Intervention Researchmentioning

confidence: 99%

Commentary on Apathy as a Model for Investigating Behavioral and Psychological Symptoms in Dementia

Gilmore‐Bykovskyi

2018

J American Geriatrics Society

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Pharmacological and Nonpharmacological Treatment for Apathy in Alzheimer Disease

Cited by 52 publications

References 163 publications

The Effectiveness of Non‐Pharmacological Interventions on Apathy in Patients With Dementia: A Systematic Review of Systematic Reviews

The Effectiveness of Non‐Pharmacological Interventions on Apathy in Patients With Dementia: A Systematic Review of Systematic Reviews

Pharmacologic Approaches for the Management of Apathy in Neurodegenerative Disorders

Commentary on Apathy as a Model for Investigating Behavioral and Psychological Symptoms in Dementia

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