The brief dimensional apathy scale (b-DAS): A short clinical assessment of apathy

Ratko Radakovic, Sarah McGrory, Siddharthan Chandran, Robert Swingler, Suvankar Pal, Laura Stephenson, Shuna Colville, Judith Newton, John Starr, Sharon Abrahams

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Apathy is a prominent syndrome across neurodegenerative diseases. The Dimensional Apathy Scale (DAS) assesses three apathy subtypes, Executive, Emotional, Initiation and is sensitive and valid in amyotrophic lateral sclerosis (ALS), Alzheimer’s Disease (AD) and Parkinson’s Disease. This study describes the development of the brief DAS (b-DAS), which will enable apathy to be swiftly detected in the clinic.

Method: 102 ALS and 102 AD patients’ previously collected data was used. Mokken analyses was performed on item-level data of each informant/carer-rated DAS subscale (Executive, Emotional and Initiation) for the initial scale reduction. Item-total correlational analyses against standard apathy (convergent validity criteria) and depression (divergent validity criteria) measures and qualitative examination of items aided final item selection. Receiver Operating Curve Analysis determined optimal cut-offs for the reduced subscales. Results: Mokken analyses suggested unidimensionality of each DAS subscale. Three items were removed that failed to satisfy monotone homogeneity model requirements, 3 items were removed due to validity criteria not being met and 6 items were removed due to a combination of lower item scalability and item-total correlations. Item-theme examination further reduced the b-DAS to 9 items, 3 per subscale, with a supplemental awareness deficit assessment being added. Sensitivity and specificity-based optimal cut-offs were calculated for each b-DAS subscale.

Conclusions: The study presents the b-DAS, an informant/carer-based robust yet short multidimensional apathy instrument with good convergent and divergent validity, with recommended clinical cut-offs. The b-DAS is appropriate for use in the clinic and for research to quickly and comprehensively screen for apathy subtype impairments.
Original languageEnglish
JournalClinical Neuropsychologist
Early online date3 Jun 2019
DOIs
Publication statusE-pub ahead of print - 3 Jun 2019

Keywords

  • apathy
  • assessment
  • short form
  • dementia
  • amyotrophic lateral sclerosis

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