Apathy is a debilitating and underrecognized syndrome that affects the vast majority of individuals with dementia, results in functional impairment among patients and causes stress among their caregivers. Accurate discrimination of the symptoms of apathy from depression is necessary for optimal treatment. The careful comparison of the symptoms of dysphoria versus symptoms of amotivation is recommended, and a number of instruments have been developed to aid in the discrimination of apathy from depression.
Cholinesterase inhibitors have been shown to reduce the neuropsychiatric symptoms of AD and vascular dementia with apathy showing the most consistent gains. The magnitude and persistence of these changes remains a topic for future research. Traditional antidepressants, activating neurologic agents and combined pharmacological-behavioral treatments also hold promise for the treatment of apathy, but controlled large-scale clinical trials are lacking. For more detailed reviews, the reader is referred to Boyle and Malloy (2004) and Wynn and Cummings (2004).
Dr. Malloy is associate professor at Brown Medical School and co-director of the Butler Hospital Memory Disorders Program.
Dr. Boyle is a neuropsychologist
with the Rush Alzheimer's Disease
Birks J, Grimley Evans J, Iakovidou V, Tsolaki M (2000), Rivastigmine(Drug information on rivastigmine) for Alzheimer's disease. Cochrane Database Syst Rev (4):CD001191 [update].
Birks JS, Harvey R (2003), Donepezil(Drug information on donepezil) for dementia due to Alzheimer's disease. Cochrane Database Syst Rev (3):CD001190 [update].
Boyle PA, Malloy PF (2004), Treating apathy in Alzheimer's disease. Dement Geriatr Cogn Disord 17(1-2):91-99.