What is apathy?
Apathy is typically defined as a lack of motivation or disinterest in certain activities.1 It can be due to a dementia diagnosis and can impact their quality of life and their care partners' quality of life. When not identified correctly, apathy can look very similar to depression or laziness. For most persons living with dementia this is not usually the case, as apathy might be mistaken for depression.
What is the prevalence of apathy in persons with dementia?
Apathy is a very common behaviour associated with dementia. Research has found that approximately 70% of persons living with Alzheimer's disease exhibit apathetic behaviours.2-6
What is the impact of apathy?
Apathy can affect not only persons living with dementia but their care partners as well in terms of their emotional well-being. If unrecognized, apathy can have a greater impact, as persons with dementia who are more motivated typically experience a reduction in cognitive decline.
How can we better support persons living with dementia who experience apathetic behaviours?
It is important to know the signs of apathy before jumping to conclusions. If your loved one with dementia is less willing to participate in activities, carry out activities of daily living, or might struggle getting out of bed, they could be showcasing apathetic behaviours.
As a way to address this, there are limited pharmacological interventions, but more non-pharmacological interventions that are better suited to supporting people with dementia to live well. For example, therapeutic recreational activities can help to improve their quality of life and boost their mood. Activities that include stimulation and creativity have been found to have a positive impact. Other activities include cooking, Montessori methods, music, exercise, and pet companionship.1
We are hopeful at Marlena Books that reading would also help to improve quality of life and reduce apathetic behaviours as it is a cognitively stimulating activity, however, we can not make any conclusions given the scant research on reading and dementia.
So what does this all mean?
Based on all of this information, now what can you do to best support yourself, as a care partner, and also your loved one with dementia? Our advice is to continue to keep your loved one with dementia engaged in activities, socializing with others, and maintain their sense of community. This will help to boost their mood and also offer them with a sense of purpose. For yourself, recognize the signs of apathy and gain support from others. Whether that be enrolling your relative with dementia in an adult day program or seek a respite program, take time for yourself to regroup and come back with a positive attitude. While some days you might need a rest, it is important to continue keeping both yourself and your loved one engaged in recreation and social opportunities, as it has numerous benefits.
References
1. Brodaty, H. & Burns, K. (2012). Nonpharmacological management of apathy in dementia: A systematic review. The American Journal of Geriatric Psychiatry, 20(7), 549-564. doi: 10.1097/JGP.0b013e31822be242
2. Robert, P. H., Darcourt, G., Koulibaly, M. P., Claret, S., Benoit, M., Garcia, R., Dechaux, O., & Darcourt, J. (2006). Lack of initiative and interest in Alzheimer's disease: A single photon emission computed tomography study. European Journal of Neurology, 13(7), 729-735. doi: 10.1111/j.1468-1331.2006.01088.x
3. Marin, R. S., Firinciogullari, S., & Biedrzycki, R. C. (1994). Group differences in the relationship between apathy and depression. The Journal of Nervous and Mental Disease, 182(4), 235-239. doi: 10.1097/00005053-199404000-00008
4. Benoit, M., Dygai, I., Migneco, O., Robert, P. H., Bertogliati, C., Darcourt, J., Benoliel, J., Aubin-Brunet, V., & Pringuey, D. (1999). Behavioural and psychological symptoms in Alzheimer's disease. Relation between apathy and regional cerebral perfusion. Dementia and Geriatric Cognitive Disorders, 10(5), 511-517. doi: 10.1159/000017198
5. Hart, D. J., Craig, D., Compton, S. A., Critchlow, S., Kerrigan, B.M., McIIroy, S. P., & Passmore, A. P. (2003). A retrospective study of the behavioural and psychological symptoms of mid and late phase Alzheimer's disease. International Journal of Geriatric Psychiatry, 18(11), 1037-1042. doi: 10.1002/gps.1013
6. Starkstein, S. E. Jorge, R., & Mizrahi, R. (2006). The prevalence, clinical correlates, and treatment of apathy in Alzheimer's disease. European Journal of Psychiatry, 20(2), 96-106.