Apathy has negative implications for the quality of life of patients and the long-term outcome. It’s often one of the first symptoms of Alzheimer’s disease and other forms of dementia , which damage the brain.
apathy used in a sentence – Prognostic Importance Of Apathy In Syndromes Associated With Frontotemporal Lobar Degeneration
Apathy is a lack of feeling, emotion, interest, or concern about something. Apathy is the most common neuropsychiatric symptom of dementia, with a bigger impact on function than memory loss – yet it is under-researched and often forgotten in care. A new study has found that apathy is present nearly half of all people with dementia, with researchers finding it is often distinct from depression.
There has also been some consideration that treatment may vary depending on the subtypes of apathy. Three subtypes of apathy have been proposed: emotional-affective (motivation), cognitive (planning), and auto-activation (initiation) (see Levy and Dubois). For patients with both the emotional-affective and the auto-activation subtypes, treatment with dopaminergic agents may provide more benefit. For the cognitive subtype, acetylcholinesterase inhibitors may provide more benefit (Pagonabarraga et al.,2015).
Impulsive and challenging social behaviors (component 3) were not a significant predictor of reduced survival, although they may increase health care costs and carer burden. The importance of apathy, rather than disinhibition, in causing functional impairment and disability has been reported in bvFTD, perhaps because isolated disinhibition is unusual in bvFTD. 16 Our study extends this result to other syndromes associated with FTLD.
Apathy is not new. It’s not like I didn’t have to deal with in in high-school. But, it’s different here. We spend our time studying ancient Greek philosophy and contemplating life’s greatest questions, picking apart the text for meaning that will illuminate us to the wonders of Western civilization, yet people don’t apply their critical thinking to the challenges facing us in the world today. In high-school there was the greater public of the school who was apathetic. Here, even those in the sustainability society are stuck in the mindset of cute little environmental projects” like residence gardens and crafts. While those serve a purpose and are great for getting people excited about nature and the environment, they will NOT create real change.
While apathy can be hard to diagnose and treat, there are ways to manage it. Some people with Alzheimer’s disease feel more motivated when they take drugs called cholinesterase inhibitors, such as donepezil ( Aricept ), galantamine ( Razadyne ), or rivastigmine ( Exelon ). Antidepressants don’t seem to help, and they may even make apathy worse.
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.
Logistic regression was used to compare the occurrence of a behavioral disturbance in each of the 12 behavioral clusters as a function of the dementia and apathy subgroup (no apathy at all, affective apathy, and nonaffective apathy). The 2 Helmert contrasts were included in the regression as were interactions between the dementia group and each of the Helmert contrasts. If neither interaction was found to be statistically significant, they were both removed from the model, and parameters were reestimated. All hypothesis tests reported in the Results” section were performed at an α level of05.
Remember that apathy is a non-motor symptom of PD and is not under the control of the person with PD. Keeping this in mind should help care partners as well as people with PD refrain from blaming themselves about their lack of initiative.
But it isn’t the same thing as depression , though it can be hard to tell the two conditions apart. Feeling “blah” about life is common in both conditions. It’s not sadness or anger either. Rather than feeling these emotions, you don’t feel much of anything. Things that used to make you happy don’t excite you anymore. You no longer feel motivated to achieve your goals.
The problem of boredom as a health care issue has been subsumed under research on other complaints such as depression, apathy, or fatigue. Apathy may cause disinterest in many aspects of life. You may be indifferent when you meet new people or try new things. You may show no interest in activities or addressing personal issues.
Try to continue with activities you enjoy. If you have stopped most activities, restart them one at a time. Research shows that keeping active can improve your mood and make you feel more positive about yourself.
In contrast to such state changes in mood, trait factors have also been implicated in Parkinson’s disease. A so called parkinsonian personality”—characterised by inflexibility, moral rigidity, and introversion—has been described 29, 30 and is considered to be directly related to the underlying disease pathophysiology. 31 Personality theorists such as Cloninger have sought to integrate neurobiological models of neurotransmitter systems with specific aspects of personality such as novelty seeking and reward dependency. 32 This raises the possibility that apathy and specific personality traits in Parkinson’s disease may reflect the same neuropathological substrate. To date, this association has not been assessed.
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.
This division into three groups of mechanisms is based on clinical observations of patients with brain lesions affecting the PFC and the basal ganglia. Each of the three groups of mechanisms can be ascribed to lesions of different PFC-basal ganglia territories as follows: ‘emotional-affective’ to the orbital-medial PFC and presumably to its connected region within the striatum, namely the ventral striatum, ‘cognitive’ to the lateral PFC (and to its striatal input, namely the dorsal caudate nuclei) and ‘auto-activation’ to basal ganglia lesions that usually affect both the cognitive and limbic territories bilateral GPi (internal portion of the globus pallidus) or bilateral paramedian thalamic lesions and also the dorsal-medial aspect of the PFC (see Table 1-3 ).
Dr. Padala is conducting a VA-funded placebo-controlled study for apathy treatment in 60 veterans with Alzheimer’s dementia. He said that early study results have been promising, as illustrated by the comments from the wife of an Alzheimer’s patient who is taking ritalin.
Survival rates differed significantly between diagnostic groups from PiPPIN assessment (A: log-rank Mantel-Cox χ2 = 20.9, df = 3, p < 0.001; pairwise comparisons revealed significant differences for PSP vs PPA χ2 = 17.0, p < 0.001; PSP vs bvFTD χ2 = 6.0, p < 0.05; CBS vs PPA χ2 = 14.0, p < 0.001; and CBS vs bvFTD χ2 = 4.6, p < 0.05), and from onset (B: log-rank Mantel-Cox χ2 = 18.0, df = 3, p < 0.001; pairwise comparisons revealed significant differences for PSP vs PPA χ2 = 11.2, p = 0.001; PSP vs bvFTD χ2 = 4.8, p < 0.05; CBS vs PPA χ2 = 13.5, p < 0.001; CBS vs bvFTD χ2 = 5.7, p < 0.05). bvFTD = behavioral variant frontotemporal dementia; CBS = corticobasal syndrome; df = degrees of freedom; PiPPIN = Pick's Disease and Progressive Supranuclear Palsy Prevalence and Incidence; PPA = primary progressive aphasia; PSP = progressive supranuclear palsy.
den Brok MG, van Dalen JW, van Gool WA, Moll van Charante EP, de Bie RM, Richard E. Apathy in Parkinson’s disease: A systematic review and meta-analysis. Mov Disord. 2015;30(6):759-69. Brown RG, Marsden CD. Cognitive function in Parkinson’s disease: from description to theory. Trends Neurosci1990;13:21-9.
Here, we adapted the Lille Apathy Rating Scale (LARS) 13 , a tool first developed to measure apathy in PD, to produce and validate a novel measure to assess and dissect the profile of apathy in healthy people: the Apathy Motivation Index (AMI). Using the most rigorous psychometric procedures, we then dissected out the different factors that comprise the AMI and determined whether depression, anhedonia and fatigue are related to distinct profiles of apathy. We hypothesized that, after developing our new index, we would identify distinct subtypes of apathy in the general population and that these subtypes would be differentially associated with depression, anhedonia and fatigue.
People experiencing apathy may struggle with defeating their feelings of indifference. An important first step in combating apathy that occurs alone or as a symptom of a mental health condition is to identify any possible triggers or causes and make adjustments to eliminate those triggers from one’s life. Changing a daily routine by adding new activities and scheduling enough events to fill the day can also help keep the mind busy and help prevent apathy. A person can also make small goals and direct personal areas of strength toward those goals or make a larger goal to work toward slowly.
The PGI-I is a scale that measures the participant’s perception of improvement at the time of assessment compared with the start of treatment. The score ranges from 1 (very much better) to 7 (very much worse). The LS Mean Value was calculated from an MMRM model with terms of treatment, pooled investigator, visit, and treatmentvisit.
505 people (211 males, 271 females, 23 gender undisclosed, mean age = 28.7 years, SD = 14.9, range = 16-85, N = 27 age undisclosed), recruited from the local communities via online adverts and posters, completed a preliminary 51-item scale. All participants gave written informed consent and the study was approved by the University of Oxford ethics committee. Methods were carried out in accordance with the relevant guidelines and regulations.
Results: Patients with Parkinson’s disease had significantly higher levels of apathy than equally disabled osteoarthritic patients. Furthermore, within the Parkinson sample, levels of apathy appear to be unrelated to disease progression. The patients with Parkinson’s disease with the highest levels of apathy where not more likely to be depressed or anxious than those with the lowest levels of apathy, though they did show reduced hedonic tone. No differences in personality traits were detected in comparisons between patients with Parkinson’s disease and osteoarthritis, or between patients in the Parkinson group with high or low levels of apathy. As a group, the patients with Parkinson’s disease tended not to differ significantly from the osteoarthritic group in terms of cognitive skills. However, within the Parkinson’s disease sample, the high apathy patients performed significantly below the level of the low apathy patients. This was particularly evident on tests of executive functioning.