Abstract
The aim for this article is to review the frequency, clinical correlates and treatment of apathy in Alzheimer's disease. Apathy is currently defined as diminished motivation as expressed in poor goal-oriented behaviours and cognitions. A structured clinical interview and a specific set of diagnostic criteria to diagnose apathy in dementia have been recently validated. There are several valid and reliable scales to measure the severity of apathy in adults with neuropsychiatric disorders. Apathy is present in about 20% of patients with mild dementia and in 60% of those with severe dementia. Among patients with Alzheimer's disease, apathy is significantly associated with older age, the presence of depression, and more severe cognitive and functional deficits, and also predicts a faster cognitive and functional decline. The mechanism of apathy in neuropsychiatric disorders is still unknown, but several studies suggest an important role for frontal lobe and basal ganglia dysfunction. There are no specific randomized controlled trials of psychoactive compounds to treat apathy in neuropsychiatric disorders. Evidence from case reports and small case series suggest the usefulness of psychostimulants to treat apathy in traumatic brain injury, whereas pharmacological trials for behavioural and psychological problems in dementia suggest that anticholinesterases may have some efficacy.
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