A review of the latest research into apathy, common in neurocognitive disorders including mild cognitive impairment (MCI) and Alzheimer’s disease, was recently published by the Alzheimer’s Association International Society to Advance Alzheimer’s Research and Treatment (ISTAART) Neuropsychiatric Syndromes Professional Interest Area (NPS-PIA) Apathy Workgroup. The review was published in the journal, Alzheimer’s & Dementia.
Co-author and the Centre for Healthy Brain Ageing (CHeBA) Co-Director Professor Henry Brodaty said that the high prevalence of apathy makes it an important target for intervention.
“Research indicates that the prevalence of apathy increases with disease progression, but we also find that apathy affects the full spectrum of people from those with normal cognitive function through to people with neurological conditions such as Alzheimer’s disease, Parkinson’s disease and stroke,” said Professor Brodaty.
“Apathy is characterised by a loss of motivation, decreased interest in daily activities and less emotional responsiveness. The burden of apathy is especially high for family carers and it is important that we improve our efforts to ameliorate the effects.”
The review explored three major areas of current research relevant to apathy treatment: improved diagnostic criteria and novel instruments for measurement; neurobiological understandings of the disease, including genetic, imaging and animal models of research; and intervention trials, including drug and behaviour/activity modifications.
The review highlighted a number of factors which can be confused with depression, medication effects, physical conditions resulting in pain or lethargy, premorbid behavioural dispositions and environmental factors. Research studies are also challenged by the difficulty in recruiting patients with apathy.
Professor Brodaty explained a number of pharmaceutical, psychological and environmental approaches have been shown to have limited effectiveness in overcoming apathy.
“Building interventions based on individual interests and arranging schedules of structured activities are useful avenues for future research. Ultimately, we also need interventions which work across different contexts, particularly for people with dementia, such as in home care and nursing home settings.”