Apathy In Adults Research Articles

Association between cannabis use disorder and greater apathy in adults with HIV

BackgroundApathy is prevalent among people with HIV (PWH) and is associated with poor clinical outcomes. Cannabis use and Cannabis Use Disorder (CUD) are also disproportionately prevalent among PWH. CUD and younger onset of cannabis use may be linked to apathy in the general population; however, patterns of use most strongly associated with apathy have not been firmly established, and it is unclear whether cannabis use is linked to apathy in PWH. MethodsWe examined associations in 311 adult PWH between Apathy Evaluation Scale-Self (AES-S) scores and CUD history (current/past/no CUD/no cannabis use) and between AES-S scores and age of CUD onset (adolescent-onset/adult-onset). We also examined robustness of associations to adjustment for depressive symptoms (which may overlap with apathy symptoms) and alcohol use. ResultsCurrent CUD was associated with greater AES-S scores relative to cannabis users with no CUD history (β = 2.13, 95 % CI = 0.37–3.90, p = 0.018). Adolescent-onset CUD was not associated with greater apathy relative to adult-onset CUD (β = 0.56, 95 % CI = -2.57 – 3.68, p = 0.7). Associations became nonsignificant after adjustment for depressive symptoms, but not after adjustment for alcohol use. Alcohol use was correlated with apathy (r = 0.19, 95 % CI: 0.076–0.29, p = 0.001). ConclusionsCannabis Use Disorder and at-risk alcohol use are associated with apathy among PWH; this finding highlights the need for substance use disorder prevention and treatment among PWH.

Clinical utility and psychometric properties of the Apathy Evaluation Scale.

The Apathy Evaluation Scale (AES) is a tool utilized with individuals with brain injury, neurocognitive disorders, and other mixed populations to quantify and characterize apathy in adults. The scale "treats apathy as a psychological dimension defined by simultaneous deficits in the overt behavioral, cognitive, and emotional concomitants of goal-directed behavior." It has three versions: self-rated (AES-S), clinician-rated (AES-C), and informant-rated (AES-I). Using factor analysis, Marin and colleagues identified three factors for the scale, including general apathy, disinterest or amotivation, and lack of concern. The psychometric properties of the AES have been examined in various clinical cohorts, including individuals with Alzheimer's disease (AD), traumatic brain injury (TBI), acquired brain injury, multiple sclerosis, severe mental illness, and cognitively healthy middle-aged cohort who are at risk for AD. The AES is a useful, reliable, and valid instrument to quantify and measure severity of apathy symptoms in adults. It is important to note that the AES-C and AES-S were able to discriminate apathy from depression and anxiety better than the AES-I did. It has been translated into Japanese, Portuguese, German, and Turkish. As a neuropsychiatric symptom, apathy should be measured in examining problems of relevance to psychology, psychiatry, and neurology, which may aid in understanding motivation, prognosis, and differential diagnosis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

F273. Plasma Soluble CD14 is Associated With Apathy in Adults With a History of Methamphetamine Dependence

F273. Plasma Soluble CD14 is Associated With Apathy in Adults With a History of Methamphetamine Dependence

Interventions for apathy after traumatic brain injury

Apathy is a deficiency in overt behavioural, emotional and cognitive components of goal-directed behaviour. It is a common occurrence after traumatic brain injury (TBI), with widespread impact. We have systematically reviewed studies examining the effectiveness of interventions for apathy in the TBI population. To investigate the effectiveness of interventions for apathy in adults who have sustained a TBI. This was evaluated by changes in behavioural, cognitive and emotional measures of apathy. We searched the following databases up to January 2008: CENTRAL (The Cochrane Library 2008, Issue 1), Database of Abstracts of Reviews of Effects, ACP Journal Club, MEDLINE (1950 to Jan 2008), EMBASE (1980 to Jan 2008), PsycINFO (1806 to Jan 2008), CINAHL (1982 Jan 2008), PsycBITE, AMED (1985 to Jan 2008), www.controlled-trials.com, www.clinicaltrials.gov and www.actr.org.au.The Cochrane Injuries Group's Specialised Register was searched to Jan 2009. Additionally, we examined key conference proceedings and reference lists of included trials to identify further studies meeting the inclusion criteria. Randomised controlled trials (RCTs) of interventions specifically targeting apathy for people with TBI. Two authors (ALB and RLT) independently assessed studies for inclusion. We rated the methodological quality of included studies and extracted data. We identified one trial that satisfied the inclusion criteria for this review. This trial (N = 21) showed that cranial electrotherapy stimulation (CES) decreased inertia, which is a component of apathy, while no changes were seen in the sham treatment or no treatment control groups. Given that no between-group analysis was reported, it was not possible to determine if the CES treatment group improved significantly more than the control group. No evidence was provided to support the use of CES treatment for inertia, a component of apathy. Between-group statistical analyses were not conducted and it was therefore not possible to determine the efficacy of the treatment relative to no treatment or sham treatment. Results regarding the effectiveness of treatment can only be inferred, and this evidence is based on only one trial with a small sample size. More randomised controlled trials evaluating different ways of treating apathy would be valuable. Trials should have larger sample sizes and use rigorous research designs and statistical analyses appropriate for examining between-group differences.

The prevalence, clinical correlates and treatment of apathy in Alzheimer's disease

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.