Apathy as a diagnosis in dementia

Sunnybrook researcher Dr. Krista Lanctôt, a senior scientist in the Hurvitz Brain Sciences Research Program, led an international expert working group that has developed diagnostic criteria for apathy in neurocognitive disorders (NCD), including dementias such as Alzheimer’s disease. The findings have been published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

“By defining apathy clinically and for research, we aim to increase recognition and knowledge about the diagnosis and enhance the ability for clinicians to identify apathy and distinguish it from other symptoms, treat it effectively, and evaluate new treatments for Alzheimer’s disease and other dementias,” says Dr. Krista Lanctôt.

In the paper researchers note “Apathy is broadly understood to refer to a lack of interest, enthusiasm, or concern (Oxford Dictionary).”

Apathy is one of the most common neuropsychiatric symptoms in NCDs. However, to date, there has been no consistent definition or diagnostic criteria for apathy. The term was considered a symptom of dementia rather than a diagnosis. In general, apathy in NCD has been associated with faster progression to dementia, increased caregiver burden, and lower quality of life.

The International Society for CNS and Methodology (ISCTM), which consists of leaders from academia, industry, regulatory experts, and clinicians formed an Apathy Work Group and identified a need to update the diagnostic criteria for apathy specifically in NCD to provide a more consistent definition of the term.

ISCTM’s Apathy Work Group criteria for apathy includes: Symptoms persistent or frequently recurrent over at least four weeks, a change from the patient’s usual behaviour, and including one of the following: diminished initiative, diminished interest, or diminished emotional expression/responsiveness; causing significant functional impairment and not exclusively explained by other etiologies.

Researchers say while it is still early in the process and continued research is needed to formalize the criteria before it is utilized at the clinical level, this an important step that will help pave the way for the exploration and approval of innovative interventions for apathy in the future.

Read the article in Alzheimer’s & Dementia

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