A novel assessment and profiling of multidimensional apathy in Alzheimer's Disease

Ratko Radakovic, John M Starr, Sharon Abrahams

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Apathy is a complex multidimensional syndrome frequently reported in Alzheimer’s disease (AD) and is associated with impaired awareness. Here we present a psychometrically robust method to profile apathy in AD. Objectives: To determine the validity and reliability of a multidimensional apathy measure, the Dimensional Apathy Scale (DAS), and explore the apathy subtype profile and its associations in AD. Methods: 102 people with AD and 55 healthy controls were recruited. Participants completed the DAS, the Apathy Evaluation Scale (AES), Geriatric Depression Short form (GDS-15), and Lawton Instrumental Activities of Daily Living (LIADL). Psychometric properties of the DAS were determined. AD-Control comparison was performed to explore group differences on the DAS. Latent Class Analysis (LCA) was used to explore the profile of apathy in AD. Results: The DAS had a good to excellent Cronbach’s standardized alpha (self-rated = 0.85, informant/carer-rated = 0.93) and good convergent and divergent validity against standard apathy (AES) and depression (GDS-15) measures. Group comparison showed people with AD were significantly higher for all apathy subtypes than controls (p < 0.001), and lacking in awareness over all apathy subtype deficits. LCA showed three distinct AD subgroups, with 42.2% in the Executive-Initiation apathy, 28.4% in the Global apathy, and 29.4% in the Minimal apathy group. Conclusions: The DAS is a psychometrically robust method of assessing multidimensional apathy in AD. The apathy profiles in AD are heterogeneous, with additional specific impairments relating to awareness dependent on apathy subtype.
Original languageEnglish
Pages (from-to)57-67
JournalJournal of Alzheimer's Disease
Volume60
Issue number1
Early online date25 Jul 2017
DOIs
Publication statusPublished - 29 Aug 2017

Keywords

  • Alzheimer’s disease
  • apathy
  • awareness
  • behavior rating scale
  • psychometrics
  • syndrome

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