Apathy is a state of indifference, characterised by a lack of emotion, motivation or interest. For clinicians who might want to screen patients with diabetes for apathy, the test that the study used takes too long to administer in a busy office.
apathy in a sentence government – ‘The Most Dangerous Thing In The World Is Apathy’ Harvard Gazette
Apathy is a lack of feeling, emotion, interest, or concern about something. Table 3 gives the prevalence of psychotropic drug classes most commonly prescribed to this sample. Serotonergic agents (including selective serotonin reuptake inhibitors and trazodone hydrochloride) were more commonly prescribed to patients with FTD, whereas cholinesterase inhibitors were more frequently used by patients with DAT at the time of NPI administration. Antipsychotic medication use was not common for either group.
The authors hypothesized that apathy may occur more frequently among people with Parkinson’s disease than those with dystonia because Parkinson’s may have a greater disruptive effect on frontal subcortical systems such as the anterior cingulate-mesial frontal cortex that are thought to be involved in apathy.
Expert explanation: Depression and apathy occur in many persons with dementia. Apathy is different from depression. With apathy, a person may experience a lack of motivation, effort or energy to do everyday tasks, no longer have interest in talking with others or participating in activities, or show a lack of reaction to people or things that occur. People with depression may be sad or tearful, irritable, restless and have feelings of low self-worth. People with depression may also have sleep problems, loss of energy and appetite changes. See medical attention if the behavior is significant or if it is a sudden change from their usual self.
The symptoms of apathy manifested in this study did not differ based on the origin of the dementia, but the unpacking of all responses to the NPI revealed that apathy was accompanied in FTD by behavioral disturbances that conform to an orbital frontosubcortical syndrome. The findings in DAT patients with apathy defied our assumption that a damaged limbic circuit would result in affective apathy alone; behavioral and cognitive apathy domains were endorsed in DAT as frequently as in FTD, which implies the additional involvement of at least the right dorsolateral prefrontosubcortical circuit. The pathologic changes of FTD and DAT overlap considerably in location, so it is entirely possible that each may affect much of the same circuitry. Amyloid imaging studies 20 have shown burden in the frontal lobes early in DAT, and Royall et al 21 emphasized that the diagnosis of DAT is probably not made until after the disease has affected the frontal systems.
The factor analysis identified three distinct subscales, namely behavioural activation (BA), social motivation (SM) and emotional sensitivity (ES). BA relates to an individual’s tendency to self-initiate goal-directed behaviour, SM examines a person’s engagement of social interactions and ES probes an individual’s feelings of positive and negative affection. While SM correlated with BA and ES, BA did not associate with ES. (: p < 0.01).
The study was conducted by recruiting 100 patients from a diabetes clinic at the medical center. Each person was tested for evidence of depression and took three psychological tests-the Apathy Evaluation Scale (clinician version), the Hamilton Rating Scale for Depression, and the Self-Care Inventory, which rates adherence to diabetes management recommendations (Diabetes Res. Clin. Pract. 2008;79:37-41). Data from those tests were then correlated with patient demographic and laboratory data.
Patients such as the one in the above example tend to say that although they like the fact that they aren’t bothered by life as usual, they want to be able to experience their emotions: “But doctor, I want to feel something!” they say. In most cases, the experience of having no emotional response to life events is unacceptable to the patient, and although the depression is “cured,” in almost all cases patients request a change in antidepressants.
Exercise. Physical activity is probably the last thing you want to do when you’re tired and unmotivated. It sounds counterintuitive, but exercise is actually helpful for apathy. Listen to your body and know your limits (i.e., stop if you feel pain, don’t push yourself to the point of exhaustion, etc.) but try to do something active every day — a short walk around the block or, if you have poor balance, stretching exercises on the floor. You might even want to look into group exercise classes — many are offered specifically for people with Parkinson’s or older adults.
This form, which can be called ‘cognitive inertia’, refers to the reduction in GDB due to impairments in the cognitive functions needed to elaborate the plan of actions. It results from impairments in several executive functions that are needed to plan and carry out GDB, such as impairments in planning, working memory, rule-finding and set-shifting. Patients may therefore be apathetic as a result of working memory and planning deficits (maintenance and mental manipulation of goals and subgoals), difficulty in generating new rules or strategies or difficulty in shifting from one mental and behavioral set to another. Specific cognitive tasks, such as the Wisconsin Card Sorting task (rule-finding, maintenance and set-shifting), the Tower of London task (planning) or the literal fluency task (self-activation of cognitive strategies), can be used to detect this cognitive inertia.
In order to answer the questions posed, 62 patients with either Parkinson’s disease (n = 45) or osteoarthritis (n = 17) were assessed on a range of neuropsychiatric, cognitive, and personality measures. All participants gave informed consent and were assessed in their own homes. Patients from both clinical groups were visited in the same time frame and were all assessed by the same investigator (GCP). Ethical approval was granted for the investigation of each patient group from the appropriate hospital ethics committees.
Methods: Levels of apathy in 45 patients with Parkinson’s disease were compared with a group of 17 similarly disabled patients with osteoarthritis. Additional neuropsychiatric data were collected concerning levels of depression, anxiety, and hedonic tone. Personality was assessed with the tridimensional personality questionnaire. Cognitive testing included the mini-mental state examination, the Cambridge examination of cognition in the elderly, and specific tests of executive functioning.
To understand what apathy is (and isn’t), one has to first understand what motivation is. It is said that motivation drives behavior—that to engage in goal-directed behavior, one has to be “motivated” to initiate, follow through, and complete a task. It sounds like a cognitive characteristic that is mostly under our control, at least as long as our brains are healthy. In short, an idea has to turn into action in order for tasks to be completed.
To do this, the team recruited 51 HD patients and 26 control participants, all of whom were subjected to a battery of psychological tests. Among these tests, apathy was measured using the Apathy Evaluation Scale (AES) and the Problem Behaviors Assessment for HD (PBA). The researchers then looked for associations between these apathy scores and other psychological assessments using statistical models.
Dr. Gilbert received her MD degree at Weill Medical College of Cornell University in New York and her PhD in Cell Biology and Genetics at the Weill Graduate School of Medical Sciences. She then pursued Neurology Residency training as well as Movement Disorders Fellowship training at Columbia Presbyterian Medical Center. Prior to coming to APDA, she was an Associate Professor of Neurology at NYU Langone Medical Center. In this role, she saw movement disorder patients, initiated and directed the NYU Movement Disorders Fellowship, participated in clinical trials and other research initiatives for PD and lectured widely on the disease.
As with depression, comparable levels of anxiety were found in the apathetic and non-apathetic patients. The previous research on this issue has been inconclusive: although in one study anxiety was found to be associated with apathy in Parkinson’s disease patients, 6 in another no relation was detected. 2 Our present study employed for the first time an independent measure of hedonic tone. Using the standard criterion for the scale used, 50 6.7% of the Parkinson’s disease sample were classified as anhedonic,” although there was no overall difference between the osteoarthritic and Parkinson’s disease groups in hedonic tone. However, mean levels were significantly reduced in the high apathy group compared with the low apathy group, supporting the idea that loss of enjoyment or pleasure is a feature of the condition.
This year, 65 percent report they voted, but, according to Brookings , only half of eligible Millennial voters actually did. How can a demographic that self-reports as politically conscious, advocates for change, and lauds the power of the ballot be counted on to vote only half the time? Welcome to the Harvard Public Opinion Project, where we analyze the land of peculiar politics where apathy meets activism.
In a recent study out of the University of Geneva, Dr. Gilles Allali and colleagues wanted to see if the presence of apathy in patients with iNPH would predict which patients would show an improvement in gait after shunt surgery.
Leentjens AF, Verhey FR, Luijckx GJ, et al. The validity of the Beck depression inventory as a screening and diagnostic instrument for depression in patients with Parkinson’s disease. Move Disord2000;15:1221-4.
University is a new world. People are free from the constraints of parental supervision and take that freedom to mean that it is time for some DRASTIC action. For most, that means parties, that does not mean banding together to overcome our capitalistic and consumer society in hopes of a better future for ourselves and anyone who comes after us. For me, it means facing a new crew of apathetic young adults who don’t care about the climate crisis. Or, if they do, not caring enough to abandon their late night party habits in exchange for rallies and advocacy for action on climate change.
Apathy is increasingly being recognized as a common and clinically significant neurobehavioral syndrome. Previously reported prevalence of apathy in patients with clinically diagnosed dementia of Alzheimer type (DAT), the most common type of dementia among elderly individuals, ranges from 36% to 88%. 1 A similar prevalence of apathy has also been reported in frontotemporal dementia (FTD; 60%-90%). 2 – 4 Although physicians recognize the prevalence of apathy in patients with dementia, little has been reported about the pathophysiology, characteristics, and behavioral associations of apathy.
Currently, there are no approved treatments for apathy. Apathy has traditionally been very difficult to treat in patients with Parkinson’s disease (PD). However, apathy was one of the four most important determinants of health-related quality of life in a recent study by Skorvanek et al. It has also been found to cause greater impairment in the patient’s ability to perform activities of daily living, and greater caregiver burden (see Leiknes et al., 2010, and Leroi et al.,2012). This indicates that treatment for apathy may result in improvement of quality of life for both the patient and caregiver.
It only takes one apathetic employee to derail a hospital leader’s efforts to improve his or her organization. A disengaged employee might fail to wash his hands, forget to verify a dosage of medication, or close up a patient without checking for a stray sponge or instrument left inside. People-and the decisions they make on a daily basis-are the most important part of the care improvement process.
Lieberman A, Ranhosky A, Korts D. Clinical evaluation of pramipexole in advanced Parkinson’s disease: results of a double blind, placebo controlled, parallel-group study. Neurology1997;49:162-8. You may also show chronic apathy symptoms if you have a progressive disorder such as Parkinson’s or Alzheimer’s. Treating the underlying condition can help improve apathy.
Apathy may herald cognitive decline and dementia in Parkinson’s disease. Mov Disord 2009;24:2391-2397. Cole SA, Woddard JL, Juncos JL, et al. Depression and disability in Parkinson’s disease. J Neuropsychiatry Clin Neurosci1996;8:20-5.
While it can often be confused with Stoicism , apathy is much worse than merely not showing feelings, as the person who is apathetic HAS no feelings. Complete lack of emotion or motivation about a person, activity, or object; depression; lack of interest or enthusiasm; disinterest.
The whole ordeal taught me that we should pay attention when we are apathetic. Maybe the voice of apathy is screaming to tell us that we have to change our current crappy situation. Your facial expressions may not appear to change. You may exhibit a lack of effort, planning, and emotional response. You may also spend more time by yourself.
It is challenging to study the independent effect of apathy on cognitive function because apathy often coexist with cognitive dysfunction (such as dementia) and depression. Apathy is more prevalent in PD patients with depression or cognitive impairment. For the PD population in general, apathy is present in about 40% of patients. However, apathy is present only in approximately 22% of the patients who do not have coexisting depression or cognitive impairment. Apathy is associated with lower MMSE scores (den Brok et al., 2015).
The cognitive, and particularly executive, dysfunction often reported in Parkinson’s disease thus seems to be most evident in those patients who show the clinical features of apathy. While possible dementia was found in only a small proportion of the patients included in the present studies, it is significant that all of them were defined as apathetic—a result consistent with the classical description of fronto-subcortical dementia, 60 where apathy is one of the defining neurobehavioural features. This raises the question of whether patients with marked apathy and associated cognitive dysfunction represent a distinct subgroup of the Parkinson’s disease population or simply an extreme of a range of dysfunction. The extent to which the presence of apathy marks a subtype of Parkinson’s disease patient may have wider implications for the prognosis and treatment of people with Parkinson’s disease.
At 30 months post assessment, 50 patients had died, including 21 PSP, 15 CBS, 5 PPA, and 9 bvFTD. The remaining patients were classified as alive” (n = 62) or were excluded because of insufficient follow-up time (n = 12). Twenty-four cases were removed list-wise during the logistic regression because of missing data of interest. The final logistic regression subset was representative of the full cohort from which the neurobehavioral profiles were derived, 10 in terms of age, sex, and diagnosis ( table 2 ).
The observation that the diagnosis category is not predictive of survival provides additional support for the transdiagnostic approach adopted by the PiPPIN study 2 , 10 and has direct implications for the design of future clinical investigations. For a clinical trial of symptomatic treatments, we propose that emphasis should be placed on recruiting patients who present with that symptom (e.g., apathy) rather than on patients defined by a diagnostic label (e.g., bvFTD). In PiPPIN, apathy (component 2) was abnormal across the diagnostic groups ( figure 1 ). Profound apathy and associated behavioral changes are increasingly recognized in PSP and CBS 33 , – , 37 despite being largely overlooked because of predominant motor impairments.