Recommendations for the non-pharmacological treatment of apathy in brain disorders

Valeria Manera, Sharon Abrahams, Luis Agüera-Ortiz, François Bremond, David Renaud, Kaci Fairchild , Auriane Hanon, Masud Husain, Alexandra König , Patricia Lockwood, Pino Maribel, Ratko Radakovic, Gabriel Robert, Andrea Slachevsky, Florindo Stella, Anaïs Tribouillard, Pietro Davide Trimarchi, Frans R.J. Verhey, Jerome Yesavage , Radia ZeghariPhilippe Robert

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Apathy is a common neuropsychiatric syndrome observed across many neurocognitive and psychiatric disorders. Although there are currently no definitive standard therapies for the treatment of apathy, non-pharmacological treatment (NPT) is often considered to be at the forefront of clinical management. However, guidelines on how to select, prescribe and administer NPT in clinical practice are lacking. Furthermore, although new Information and Communication Technologies (ICT) are beginning to be employed in NPT, their role is still unclear. The objective of the present work is to provide recommendations for the use of NPT for apathy, and to discuss the role of ICT in this domain, based on opinions gathered from experts in the field. The expert panel included 20 researchers and healthcare professionals working on brain disorders and apathy. Following a standard Delphi methodology, experts answered questions via several rounds of web-surveys, and then discussed the results in a plenary meeting. The experts suggested that NPT are useful to consider as therapy for people presenting with different neurocognitive and psychiatric diseases at all stages, with evidence of apathy across domains. The presence of a therapist and/or a caregiver is important in delivering NPT effectively, but parts of the treatment may be performed by the patient alone. NPT can be delivered both in clinical settings and at home. However, while remote treatment delivery may be cost and time-effective, it should be considered with caution, and tailored based on the patient’s cognitive and physical profile and living conditions.

Implications for Practice and Research.
NPT should be tailored to deficits (e.g., cognitive, physical), clinical objectives (e.g. prevention, intervention) and preferences (e.g. personal, sensory) of each patient. ICT may help to improve treatment personalization, increase motivation, and aid remote treatment delivery. Further structured research (e.g., RCT) is needed to determine NPT efficacy.
Original languageEnglish
Pages (from-to)410-420
JournalAmerican Journal of Geriatric Psychiatry
Issue number4
Early online date9 Aug 2019
Publication statusE-pub ahead of print - 9 Aug 2019

Keywords / Materials (for Non-textual outputs)

  • apathy
  • motivation
  • complementary therapies
  • prescriptions
  • non-drug
  • ICT
  • brain disorders


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