The mechanism, predictive value and impact of apathy in patients with Alzheimers disease and their caregivers

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Behavioural and psychological symptoms of dementia have been consistently associated with increased patients’ distress, and are considered by caregivers as the most difficult symptoms to manage. Apathy is the state of loss of motivation and emotional withdrawal that occurs in a high proportion of patients with Alzheimer’s disease. These patients require more management and support, given their reliance on others to schedule their activities and initiate behaviours even when they are still capable of performing the activities. In spite of the high frequency of apathy in dementia and the high potential of negative effects on patients and caregivers, little is known about the cause of this phenomenon, its potential influence upon the long-term progression of Alzheimer’s disease, and on its impact upon caregivers’ emotional well-being. The main aim of our proposal is to examine the mechanism, clinical relevance and impact of apathy in Alzheimer’s disease. More specifically, we will determine whether apathy predicts more severe depression, increasing motor problems, and a faster progression of cognitive and functional problems. Using state-of-the-art neuroimaging techniques we will examine the association between apathy and abnormalities in specific brain regions. Finally, we will examine whether caregivers of patients with apathy have relatively more severe emotional problems, a higher care giving burden and poor quality of life.