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

痴呆症的行为和心理症状一直与患者的痛苦增加有关，并且被护理人员认为是最难控制的症状。冷漠是一种失去动力和情绪退缩的状态，在阿尔茨海默病患者中占很大比例。这些患者需要更多的管理和支持，因为他们依赖他人来安排他们的活动和发起行为，即使他们仍然有能力执行这些活动。尽管痴呆症患者冷漠的频率很高，对患者和护理人员的负面影响也很大，但人们对这种现象的原因、对阿尔茨海默病长期进展的潜在影响以及对护理人员情绪健康的影响知之甚少。我们建议的主要目的是研究冷漠在阿尔茨海默病中的机制、临床相关性和影响。更具体地说，我们将确定冷漠是否预示着更严重的抑郁症，增加运动问题，以及认知和功能问题的更快进展。使用最先进的神经成像技术，我们将检查冷漠和大脑特定区域异常之间的关系。最后，我们将检验冷漠患者的照护者是否有相对更严重的情绪问题、更高的照护负担和较差的生活质量。

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.