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Apathy in Persons with Alzheimer's Disease: An Overview

Kim, Kye Y. MD; Detweiler, Mark B. MD, MS

doi: 10.1097/ACQ.0b013e3181f8bbaa
Feature Topic: Dementia Care Environments: Best Practices

Apathy is common across various neurological disorders. However, apathy is one of the earliest and probably the most persistent neuropsychiatric symptoms in patients with Alzheimer's disease. It is defined as lack of motivation and is manifested by diminution of goal-directed cognition and behavior. Apathy is linked with a faster progression of cognitive, functional, and emotional impairment. It is also associated with decreased insight. As a result, patients with apathy rely on caregivers to provide more care that results in increased stress for caregivers. Neuropathological changes in Alzheimer's disease may result in apathy by affecting the orbitofrontal and anterior cingulate circuits. Although apathy is increasingly recognized in patients with neuropsychiatric symptoms, no official diagnostic classification systems offer a definition of apathy. In this review, neuropathological correlates, neuroimaging, diagnosis, caregiving issues, and treatment are briefly discussed for clinicians who care for persons with Alzheimer's disease.

Salem Veterans Affairs Medical Center, Salem, Virginia (Drs Kim and Detweiler); and Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke (Drs Kim and Detweiler).

Correspondence: Kye Y. Kim, MD, Bldg 7-1, VA Medical Center, Salem, VA 24153 (

The authors thank Jonna Detweiler for her valuable assistance in the preparation of this manuscript.

The authors have no conflict of interest.

© 2010 Lippincott Williams & Wilkins, Inc.