Original ArticlesApathy and Executive Dysfunction in Alzheimer DiseaseEsposito, Fabienne MSc*; Rochat, Lucien MSc*; Van der Linden, Anne-Claude Juillerat PhD†; Lekeu, Françoise PhD‡; Quittre, Anne MSc‡; Charnallet, Annik PhD§; Van der Linden, Martial PhD*Author Information *Cognitive Psychopathology and Neuropsychology Unit, University of Geneva †Memory Clinic, Geneva University Hospital, Geneva, Switzerland ‡Memory Centre, Department of Neurology, University Hospital of Liège, Belgium §Neuropsychology Unit, University Hospital of Grenoble, Grenoble, France Reprints: Fabienne Esposito, MSc, Cognitive Psychopathology and Neuropsychology Unit, University of Geneva, 40, Boulevard du Pont d'Arve, CH-1211 Geneva 4, Switzerland (e-mail: Fabienne.Esposito@unige.ch). Received for publication May 7, 2009 accepted October 18, 2009 Alzheimer Disease & Associated Disorders: April-June 2010 - Volume 24 - Issue 2 - p 131-137 doi: 10.1097/WAD.0b013e3181c9c168 Buy Metrics Abstract Apathy, defined as a reduction in voluntary goal-directed behaviors, is one of the most common behavioral symptoms encountered in Alzheimer disease (AD). However, the processes underlying the different components of apathy are still unclear. The aim of this study was to explore a particularly important aspect of executive function in daily life: multitasking [assessed with the Modified Six Elements Task (MSET)], and its relationship with apathy in AD. Sixty-seven participants (37 AD patients matched with 30 control participants) were screened using the MSET. Simultaneously, a close relative of each patient was given the Apathy Inventory, which assesses 3 distinct dimensions of apathy (lack of initiative, lack of interest, and emotional blunting). AD patients presented significantly more multitasking deficits than control participants. In addition, regression analyses revealed that the number of rule breaks on the MSET (inability to perform several tasks in a predefined time observing a number of rules) was the best predictor of apathy, and especially of lack of initiative. These results suggest that the relation between lack of initiative and multitasking has a specific character and that mechanisms underlying multitasking constitute a key component of goal-directed behaviors. © 2010 Lippincott Williams & Wilkins, Inc.