REVIEW: Apathy Diagnosis, Assessment, and Treatment in Alzheimer's Disease

Abstract

Apathy is defined as a disorder of motivation. There is wide acknowledgement that apathy is an important behavioral syndrome in Alzheimer's disease and in various neuropsychiatric disorders. In light of recent research and the renewed interest in the correlates and impacts of apathy and in its treatments, it is important to develop criteria for apathy that will be widely accepted, have clear operational steps, and be easy to apply in clinical practice and in research settings. Meeting these needs was the focus for a task force that included members of the European Psychiatric Association, the European Alzheimer's Disease Consortium and experts from Europe, Australia and North America.

The Brazilian version of the Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity in dementia

“…In the original NPI-C validation, the NPI-C/Apathy domain had weaker correlation with the Apathy Evaluation Scale (0.31) (Marin et al ., 1991). We correlated this domain with the AI (Robert et al ., 2002; 2010) which is more suitable to the dementia setting. This scale is divided into three core clinical dimensions required for apathy diagnosis: lack of goal-directed behavior, lack goal-directed cognitive activity, and lack emotional reaction (Robert et al ., 2002; Robert et al ., 2010; Benoit et al ., 2012).…”

“…We correlated this domain with the AI (Robert et al ., 2002; 2010) which is more suitable to the dementia setting. This scale is divided into three core clinical dimensions required for apathy diagnosis: lack of goal-directed behavior, lack goal-directed cognitive activity, and lack emotional reaction (Robert et al ., 2002; Robert et al ., 2010; Benoit et al ., 2012). AI was validated in Brazil with good specificity (97.3%) and sensitivity (99.2%) (Stella et al ., 2013).…”

“…The estimates of convergent validity included correlations of specific domains of the NPI-C with other specific measures of NPS the Brief Psychiatric Rating Scale (BPRS; Ventura et al ., 1993); the Cohen Mansfield Agitation Index (CMAI; Cohen-Mansfield et al ., 1989); the Cornell Scale for Depression in Dementia (CSDD; Alexopoulos et al ., 1988); and the Apathy Inventory (AI; Robert et al ., 2002; 2010). One of two raters completed these four scales.…”

Measuring Life Space in Older Adults with Mild-to-Moderate Alzheimer's Disease Using Mobile Phone GPS

“…Considering previous studies did not measure apathy directly, we assume this finding to reflect symptoms associated with apathy (i.e. lack of initiative, self-motivation, and reduced responsiveness to stimuli [22]) that overlap with depressive symptoms (i.e. diminished interest and fatigue/hypersomnia).…”

Clinical Profile of Alzheimer’s Disease Non-Responder Patient

“…Studies of correlation between dopamine deficits and apathy in AD are needed to better interpret this behavioral syndrome. Of note is the concept that presence of apathy may render difficult the pharmacological approach to AD patients (See Boyle et al, 2004;Robert et al, 2010). …”