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Multidimensional apathy in behavioural variant frontotemporal dementia, primary progressive aphasia and Alzheimer’s disease

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    Rights statement: The final version of this paper has been published in Journal of Geriatric Psychiatry and Neurology , by SAGE Publications Ltd, All rights reserved. © Ratko Radacovic etal., 2020. It is available at: https://journals.sagepub.com/doi/full/10.1177/0891988720924716

    Accepted author manuscript, 422 KB, PDF document

Original languageEnglish
JournalJournal of Geriatric Psychiatry and Neurology
Early online date15 May 2020
DOIs
Publication statusE-pub ahead of print - 15 May 2020

Abstract

Apathy is prevalent in dementia, such as behavioural variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA) and Alzheimer’s disease (AD). As a multidimensional construct, it can be assessed and subsumed under a Dimensional Apathy Framework. A consistent apathy profile in bvFTD and PPA has yet to be established. The aim was to explore apathy profiles and awareness in bvFTD, PPA and AD. 12 bvFTD, 12 PPA, 28 AD patients and 20 matched controls, as well as their informants/carers, were recruited. All participants completed the Dimensional Apathy Scale (DAS), assessing Executive, Emotional and Initiation apathy subtypes, a one-dimensional apathy measure, depression measure, functional and cognitive screens. Apathy subtype awareness was determined through DAS informant/carer- and self-ratings discrepancy. Apathy profile comparison showed bvFTD patients had significantly higher Emotional apathy than AD patients (p < .01) and significantly higher apathy over all subtypes than PPA patients (p’s < .05). Additionally, bvFTD patients had significantly lower awareness for Emotional apathy (p < .01) when compared to AD and PPA patients. All patient groups had significant global apathy over all subtypes compared to controls. The emergent apathy profile for bvFTD seems to be Emotional apathy (indifference or emotional/affective neutrality), with lower self-awareness in this subtype. Further, lower self-awareness for Executive apathy (lack of motivation for planning, organisation or attention) differentiates bvFTD from PPA. Future research should investigate the cognitive and neural correlates as well as the practical impact of apathy subtypes.

    Research areas

  • Alzheimer’s disease, behavioural variant frontotemporal dementia, primary progressive aphasia, frontotemporal dementia, apathy, awareness, insight

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