A three-year study led by UNSW Sydney's Centre for Healthy Brain Ageing (CHeBA) has shown that apathy increases in Mild Cognitive Impairment and is associated with worse clinical outcomes.
The research, published in International Psychogeriatrics, was conducted across nine memory clinicals across Australia, with 185 patients - all of whom had a diagnosis of mild cognitive impairment.
Mild Cognitive Impairment is defined by deficits in cognition that are noticeable to the person or family members and can be confirmed on testing, but do not significantly interfere with functioning. It is common amongst older people, affecting between 10-35% of people aged over 65. It is considered an intermediate stage between normal ageing and dementia, though it must be noted that not all people progress in their cognitive impairment and some even revert to normal.
Lead author of the study, Dr Michael Connors, said that apathy - a disorder of motivation and goal-directed behaviour - is a common symptom in dementia, although it can also be experienced by older people without dementia.
Apathy can be difficult to recognise and is sometimes confused with depression, which it resembles.
Dr Michael Connors
According to the researchers, little research has examined apathy in people with Mild Cognitive Impairment - who are people with cognitive difficulties at high risk of developing dementia. In addition, very little research has assessed how apathy might change over time.
Approximately 2.5-7.5% of patients with Mild Cognitive Impairment in the community and 10-15% attending memory clinics develop dementia every year. With such a high incidence of dementia, significant attention has focused on identifying risk factors for progression. Apathy may predict such progression to dementia.
"In this study, we assessed both apathy and depression in people with mild cognitive impairment over a three-year period to be able to better distinguish the two symptoms," says Dr Connors.
Their findings, in combination with other recent research they have done, suggest that apathy is a marker for poor clinical outcomes in older people and across different neurocognitive disorders. The research also indicates the need to distinguish apathy and depression, with depression appearing less closely tied to the progression to dementia.
Senior author and Co-Director of CHeBA, Professor Henry Brodaty, says that "there is a need to consider those with apathy to be at high risk of further cognitive decline and to plan for such contingencies."
Given apathy's prevalence and burden, this remains an important direction for future research.
Professor Henry Brodaty
